Thyroid surgery without antibiotic prophylaxis: experiences with 1,030 patients from a teaching hospital in China

Our objective was to evaluate the outcome of thyroidectomy without the use of prophylactic antibiotics. This study was held from January 2005 to May 2012 in a teaching hospital in Dongguan, China.

A total of 1,030 thyroidectomy patients were retrospectively reviewed and basic data were recorded, including age, sex, peri-operative antibiotic use, type of thyroid surgery done, and post-operative complications. Either an open approach or an endoscopic approach was performed according to the doctor's or patient's preference following a strict aseptic technique. The drain was routinely placed. Any complications were analyzed.

A total of 834 (81 %) females and 196 (19 %) males were included, giving a ratio of 4.2:1. The average age was 38.3 years. The mean operation time was 85.3 min. Pathological type included 818 (79.4 %) nodular goiter, 34 (3.3 %) Graves' disease, 102 (9.9 %) nodular papillary hyperplasia, 12 (1.2 %) Hashimoto's disease, 62 (6 %) papillary carcinoma, and 2 (0.2 %) medullary carcinoma. Four patients had postoperative bleeding, four had temporally recurrent nerve paralysis. Only one had wound infection (0.09 %).

Antibiotic prophylaxis in elective thyroidectomy is not an essential pre-operation preparation for all patients, if guidelines for antibiotic prophylaxis in clean surgery are adhered to and surgeons have sophisticated skills in the procedure.