在初级肩膀关节整形术后,相比于塞法林,适当的万科米辛抗生素预防并不会导致感染并发症的增加
Ian M Marigi1, Kristin Yu1, Micah J Nieboer1
1Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN, USA.
Journal of shoulder and elbow surgery
|May 17, 2024
概括
塞法林和完整的万科米辛的使用在初级肩膀关节整形手术中显示出类似的传染性并发症率. 适当的抗生素选择和完整的万科米辛输液是最小化风险的关键.
科学领域:
- 整形外科手术 整形外科手术
- 预防传染病 预防传染病
- 手术预防手术预防.
背景情况:
- 静脉注射 (IV) cefazolin在肩膀关节整形术 (SA) 中显示出比IV范科米辛更低的传染性并发症.
- 之前的研究包括不完整的万科米辛管理,使其在适当指示和管理时的有效性不清楚.
- 这项研究比较了塞法林与完整的万科米辛,用于初级SA的手术预防.
研究的目的:
- 评估塞法佐林和完整的万科米辛在初级肩膀关节整形术中进行手术预防的比较疗效.
- 为了确定塞法林是否保持了与适当指示和足够管理的万科米辛相比的预防性优势.
- 评估感染并发症的发生率,包括假肢关节感染 (PJI),在初级SA.
主要方法:
- 使用IV塞法索林或完整的万科米辛对初级SA (2000-2019) 的回顾性队列研究.
- 完整的万科米辛被定义为在切口前至少30分钟输注.
- 多变量Cox比例危险回归分析了所有原因的传染性并发症和无PJI生存率.
主要成果:
- 7177个主要的SAS包括:95.8%的塞法林,4.2%的完整的万科米辛.
- 总体感染性并发症:1.6% (塞法林) 与2.3% (万科米辛) 相比,P=.352.2.
- 两组之间没有PJI (1.1%对1.0%) 或感染性再手术 (1.1%对1.0%) 的显著差异.
结论:
- 与塞法林相比,完整的万科米辛给药不会增加感染并发症或PJI的发生率.
- 预防方案应确保适用于塞法林或万科米的适合性指示.
- 完整的万科米辛注射非常重要,因为它有助于减轻初级SA的传染风险.
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