[Antibiotic transfer into tissue after total hysterectomy with special reference to the cefmetazole concentration of the retroperitoneal space exudate].

The intent of the study was to investigate the transfer of CMZ to the retroperitoneal space exudate after hysterectomy (11 cases of simple abdominal hysterectomy and 6 cases of radical hysterectomy). Concentration of CMZ in the lymphnode was also measured in 2 cases. The results were as follows. Concentration in the retroperitoneal space exudate of CMZ after administration (intravenous drip infusion 1 or 2 g/hour) reached its peak 2 hours after administration (approximately 1 hour later than its peak in the blood). The peak level in the exudate was 1/3 to 2/3 of the peak level in the blood. After 2 hours, the concentration of CMZ in the exudate decreased gradually. The concentration of CMZ in the retroperitoneal space exudate in cases of simple abdominal hysterectomy was higher than in those of radical hysterectomy. After 1 to 3 days of radical hysterectomy, the transfer of CMZ into the exudate was as good as the transfer of that in the period immediately after operation. CMZ concentration in the lymphnode in the cases of radical hysterectomy reached 9 to 13 micrograms/mg approximately 1 hour after the start of CMZ administration (d.i. 2 g in 1 hour). Research results suggest that lymph circulation, in addition to blood stream, plays an important role in the transfer of antibiotics toward the pelvic dead space.