Søndenaa K, Nesvik I, Andersen E, Natås O, Søreide J A
Department of Surgery, Rogaland Central Hospital, Stavanger, Norway.
Int J Colorectal Dis. 1995;10(3):161-6. doi: 10.1007/BF00298540.
Two prospective studies were undertaken to examine the role of bacteria in the outcome after excision and primary suture for chronic pilonidal sinus disease. In the first study 52 consecutive patients were given cloxacillin as prophylaxis. In a second randomised study 51 patients were given 2 g cefoxitin intravenously (n = 25) or no prophylaxis (n = 26). From 49 out of 98 patients (50%) no microorganisms were isolated from sinuses preoperatively. Wound complications were observed postoperatively in 61% of the patients (63/103). A postoperative bacteriology sample was positive in 47 of 49 samples (96%). Preoperative presence of bacteria was not significantly associated with wound complications. Anaerobe isolates were present in 40% of patients preoperatively whereas aerobes were cultured in 43% postoperatively. After an observation period of 30-42 months, recurrences were 13% among the patients (7/52) who had been given cloxacillin. No recurrences were seen in the last study after an observation period of 18-30 months, for an overall 7% in both studies. We conclude that preoperative bacterial isolates, usually anaerobes, in chronic pilonidal sinuses do not influence the complication rate since bacterial isolates from infected wounds are mostly aerobes.
开展了两项前瞻性研究，以检验细菌在慢性藏毛窦疾病切除及一期缝合术后预后中的作用。在第一项研究中，连续52例患者接受氯唑西林预防治疗。在第二项随机研究中，51例患者静脉注射2 g头孢西丁（n = 25）或不进行预防治疗（n = 26）。98例患者中有49例（50%）术前从窦道中未分离出微生物。103例患者中有61例（63/103）术后出现伤口并发症。49份术后细菌学样本中有47份呈阳性（96%）。术前细菌的存在与伤口并发症无显著相关性。术前40%的患者分离出厌氧菌，而术后43%培养出需氧菌。经过30 - 42个月的观察期，接受氯唑西林治疗的患者中复发率为13%（7/52）。在最后一项研究中，经过18 - 30个月的观察期未出现复发，两项研究的总体复发率为7%。我们得出结论，慢性藏毛窦术前分离出的细菌（通常为厌氧菌）不会影响并发症发生率，因为感染伤口分离出的细菌大多为需氧菌。
