Franchelli S, Leone M S, Vigna E, Raposio E, Cafiero F, Costantini M, Capuzzo R, Gipponi M, Santi P L
Istituto Nazionale per la Ricerca sul Cancro, Genova.
Minerva Chir. 1994 Jan-Feb;49(1-2):59-63.
The authors report the results of a randomized clinical trial of antibiotic prophylaxis of postoperative infection following breast reconstruction by transposition of rectus abdominis myocutaneous flap (TRAMF). The aim was to evaluate the efficacy and tolerability of a short-term parenteral prophylaxis with Teicoplanin and the end-point of the study was the evaluation of wound contamination assessed by means of microbiologic culture of drainage fluid. From October 1990 to March 1992 38 patients were recruited: 20 patients in the antibiotic prophylaxis arm and 18 patients in the control group. Analysis of drainage fluids showed a higher contamination rate (15/18 = 83%) in the control group as compared to the prophylaxis arm (2/20 = 10%) (p < 0.0001). Moreover, 11 patients in the control arm suffered from fever > 37.5 degrees C for at least 3 days as compared to 1 patient in the antibiotic prophylaxis group; the postoperative stay was 13.3 +/- 4.3 and 9.0 +/- 1.6 in the control and antibiotic arm respectively. No antibiotic related side effects were evidenced through the study. These results seem to confirm the value of parenteral short-term antibiotic prophylaxis of postoperative infection in such kind of "clean" operative procedure.
作者报告了一项关于经腹直肌肌皮瓣(TRAMF)乳房重建术后抗生素预防感染的随机临床试验结果。目的是评估替考拉宁短期胃肠外预防的疗效和耐受性,研究终点是通过引流液微生物培养评估伤口污染情况。1990年10月至1992年3月招募了38例患者:抗生素预防组20例患者,对照组18例患者。引流液分析显示,对照组的污染率(15/18 = 83%)高于预防组(2/20 = 10%)(p < 0.0001)。此外,对照组有11例患者体温超过37.5摄氏度至少3天,而抗生素预防组有1例;对照组和抗生素组的术后住院时间分别为13.3±4.3天和9.0±1.6天。研究中未发现与抗生素相关的副作用。这些结果似乎证实了在这类“清洁”手术中短期胃肠外抗生素预防术后感染的价值。