Guzmán Valdivia Gomez G, Guerrero T S, Lluck M C, Delgado F J
Department of General Surgery, Regional General Hospital No. 1 "Gabriel Mancera", Mexican Institute of Social Security (IMSS), Gabriel Mancera 222, Colonia del Valle, C.P. 03100, Mexico City, Mexico.
World J Surg. 1999 Feb;23(2):123-6; discussion 126-7. doi: 10.1007/pl00013171.
The purpose of this work was to compare the efficacy and safety of the collagen-gentamicin sponge with conventional treatment (wound open, maintaining a close observation, and cleaning it daily with antiseptics) for the prophylaxis of infection in "dirty" abdominal wounds. Seventy-three patients with dirty abdominal wounds caused by gastrointestinal tract surgery were studied. The patients were randomized in two groups: group A, open wounds, treated with local cleansing, metronidazole 20 to 40 mg/kg/day IV and gentamicin 5 mg/kg/day IV for 7 days. Group B, primary closure with collagen-gentamicin implant plus metronidazole 20 to 40 mg/kg/day IV for 7 days. Surgical wound infections were significantly reduced by the collagen-gentamicin implant. Polymicrobial infections were observed in group A, whereas the infections were caused only by a single organism in group B. In conclusion, the collagen-gentamicin implant is effective and well tolerated in the treatment of "dirty" surgical abdominal wounds because it significantly reduces the wound infection rate (p < 0.01) and shortens healing time (p < 0.001) and the period of disability.
本研究旨在比较胶原蛋白-庆大霉素海绵与传统治疗方法（伤口开放，密切观察，每天用消毒剂清洁）对“污染”腹部伤口预防感染的疗效和安全性。研究了73例因胃肠道手术导致的污染腹部伤口患者。患者被随机分为两组：A组，开放伤口，采用局部清洁、静脉注射甲硝唑20至40mg/kg/天和庆大霉素5mg/kg/天治疗7天。B组，用胶原蛋白-庆大霉素植入物进行一期缝合，加静脉注射甲硝唑20至40mg/kg/天治疗7天。胶原蛋白-庆大霉素植入物显著降低了手术伤口感染率。A组观察到多微生物感染，而B组感染仅由单一生物体引起。总之，胶原蛋白-庆大霉素植入物在治疗“污染”腹部手术伤口方面有效且耐受性良好，因为它显著降低了伤口感染率（p<0.01），缩短了愈合时间（p<0.001）和残疾期。
