Aagaard H, Noer H H, Scavenius M, Jørgensen P S, Tørholm C
Department of Orthopaedic Surgery, University of Copenhagen, Gentofte County Hospital, Denmark.
J Hosp Infect. 1994 Aug;27(4):257-62. doi: 10.1016/0195-6701(94)90113-9.
Continuous registration of operations and wound infections was used to demonstrate the effect of prophylactic antibiotics in hip fracture osteosynthesis. In order to monitor wound infections and other postoperative complications in an orthopaedic department, 2 years' data on 688 patients with hip fractures, were entered into a personal computer program. During 1990, there was no formal policy for antibiotic prophylaxis; during 1991 prophylactic cefuroxime was recommended for osteosynthesis of hip fractures. In 1990 56% of patients were given prophylaxis and in 1991 this rose to 79%. Overall, 68% of patients had prophylaxis. The overall rate of deep wound infections (DWI) was significantly lower in patients treated with prophylactic antibiotics (0.6%), compared with those without prophylaxis (4.6%). Patients with DWI were admitted to the hospital for an average of 43.7 days, compared with 14.6 days for patients without complications. We recommend the use of prophylactic cefuroxime in hip fracture osteosynthesis. Computer registration of complications is a useful method for clinical quality control in an orthopaedic department.
通过持续记录手术情况和伤口感染情况来证明预防性使用抗生素在髋部骨折内固定术中的效果。为了监测骨科病房的伤口感染及其他术后并发症，将688例髋部骨折患者的两年数据录入个人电脑程序。1990年，没有正式的抗生素预防策略；1991年，推荐对髋部骨折内固定术使用预防性头孢呋辛。1990年，56%的患者接受了预防治疗，1991年这一比例升至79%。总体而言，68%的患者接受了预防治疗。与未接受预防治疗的患者（4.6%）相比，接受预防性抗生素治疗的患者深部伤口感染（DWI）总体发生率显著更低（0.6%）。发生DWI的患者平均住院43.7天，而无并发症的患者平均住院14.6天。我们推荐在髋部骨折内固定术中使用预防性头孢呋辛。对并发症进行计算机记录是骨科临床质量控制的一种有用方法。
