Hansis M
Klinik und Poliklinik für Unfallchirurgie, Bonn.
Langenbecks Arch Chir Suppl Kongressbd. 1996;113:708-12.
In situations where the local host damage (either traumatic or iatrogenically induced) is the predominant co-factor for the development of infection, the antibiotic or other pharmacological reduction of the bacterial colonisation is of secondary or no importance at all. On the one hand, excellent hygienic conditions have reduced more and more the relative importance of the bacterial contamination in aseptic procedures. On the other hand, the surgical-technical evolution in the last 5 years (such as biological osteosynthesis, unreamed intramedullary nailing, stepwise procedures in complex fractures, initial open wound treatment and very early plastic reconstruction in open fractures) could create a significant improvement of the conditions concerning prevention and treatment of infection. Therefore, the relative importance of associated antibiotic treatment has to be considered to be essentially lower.
在局部宿主损伤（无论是创伤性还是医源性诱导的）是感染发生的主要协同因素的情况下，抗生素或其他减少细菌定植的药理学方法是次要的或根本不重要。一方面，良好的卫生条件已越来越降低无菌操作中细菌污染的相对重要性。另一方面，过去5年的外科技术发展（如生物接骨术、非扩髓髓内钉固定、复杂骨折的分步手术、开放性伤口的初期处理以及开放性骨折的极早期整形重建）能够显著改善感染预防和治疗的条件。因此，相关抗生素治疗的相对重要性必须被认为本质上更低。
