Wang Yanfei, Song Ke, Cai Songlin, Wu Weifei
The First College of Clinical Medical Science, China Three Gorges University, Yichang, Hubei Province, China.
Yichang Central People's Hospital, Yichang, Hubei Province, China.
Medicine (Baltimore). 2025 Jun 6;104(23):e42818. doi: 10.1097/MD.0000000000042818.
Despite significant advancements in clinical aseptic techniques and wound infection control, surgical site infections (SSIs) continue to pose a significant risk and complication following spinal surgery. The use of intrawound antibiotics for the prevention of SSIs after spine surgery is a controversial method. The aim of this study was to conduct a review of the current literature on the use of antibiotics in wound care and evaluate their effectiveness in preventing postoperative SSIs.
Keywords such as "spinal surgery" or "spine," "antibiotics," "local" or "topical," "prevention of infection," and "infection" were used based on PubMed, Web of Science, Cochrane, and Embase database. The literature was screened based on the title, abstract, full text reading, and extraction of relevant research data. Comparisons of the data were performed using RevMan 5.3 software.
A total of 18,922 patients from 24 studies were included in the final analysis, 8878 patients received antibiotics (experimental group) to prevent SSIs, and 10,044 patients did not receive any additional antibiotics (control group). In the experimental group, 178 patients developed SSIs, compared to 356 patients in the control group. The results of the meta-analysis indicated that the incidence of SSIs in the experimental group was significant lower than that in the control group (95% confidence interval, 0.36-0.75, P = .0004).
The topical application of antibiotics within the wound site is a crucial and efficient method to prevent SSIs after spinal surgery.
尽管临床无菌技术和伤口感染控制取得了重大进展，但手术部位感染（SSIs）仍是脊柱手术后的重大风险和并发症。脊柱手术后使用伤口内抗生素预防SSIs是一种有争议的方法。本研究的目的是对目前关于伤口护理中使用抗生素的文献进行综述，并评估其预防术后SSIs的有效性。
基于PubMed、科学网、Cochrane和Embase数据库，使用“脊柱手术”或“脊柱”、“抗生素”、“局部”或“外用”、“预防感染”和“感染”等关键词。根据标题、摘要、全文阅读和提取相关研究数据对文献进行筛选。使用RevMan 5.3软件进行数据比较。
最终分析纳入了24项研究中的18922例患者，8878例患者接受抗生素（实验组）预防SSIs，10044例患者未接受任何额外抗生素（对照组）。实验组有178例患者发生SSIs，而对照组有356例。荟萃分析结果表明，实验组SSIs的发生率显著低于对照组（95%置信区间，0.36 - 0.75，P = .0004）。
伤口部位局部应用抗生素是预防脊柱手术后SSIs的关键且有效的方法。
