定义术后抗生素使用与无并发性腹腔镜尾切除术设置中的伤口并发症之间的关系
Matthew Sturdivant1, Patrick Downs1, Jorge Lara-Gutierrez1
1General Surgery, University of Pittsburgh Medical Center (UPMC) Horizon, Hermitage, USA.
Cureus
|July 20, 2023
概括
手术后的抗生素不适用于无并发性尾炎,可能会增加伤口感染的风险. 这项研究表明,单次手术前剂量是足够的,符合基于证据的尾炎管理.
科学领域:
- 外科手术 医疗外科手术
- 传染性疾病 传染性疾病
- 基于证据的医学基于证据的医学.
背景情况:
- 尾炎是一种常见的外科诊断,为单次手术前抗生素剂量制定了指南.
- 然而,外科医生在术后使用抗生素治疗无并发性尾炎方面存在显著差异.
- 这种实践变化凸显了需要澄清术后抗生素在尾炎管理中的作用.
研究的目的:
- 在我们的机构中描述和分析术后抗生素在不复杂的尾炎后的管理.
- 评估术后抗生素使用与腹腔镜尾切除术后伤口感染率之间的关联.
- 根据未来的实践指南,在无并发性尾炎中给予抗生素.
主要方法:
- 对179名因无并发性尾炎而经历了腹腔镜尾切除术的患者的回顾性图表审查.
- 排除患有尾炎并发症或其他特定标准的患者.
- 统计分析,比较接受和不接受术后抗生素的患者之间的伤口感染率,计算几率比率.
主要成果:
- 两组之间没有发现感染率的统计学上显著差异.
- 然而,6.53的几率比率表明术后抗生素使用与增加的伤口感染率之间存在关联.
- 这表明延长抗生素疗程对手术部位感染的潜在负面影响.
结论:
- 手术后的抗生素可能不适用于非复杂的腹腔镜尾切除术,可能会增加伤口感染.
- 目前的证据支持单一的手术前抗生素剂量,在无并发病例中延长术后使用没有明显的益处.
- 建议进行进一步的大规模,多机构的研究,以加强统计学意义和指导临床实践.
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