手术期间使用抗生素是否会降低手术软组织手术患者假肢关节感染的发生率?
Kelsey Young1, Thompson Zhuang1, Sophia Mavrommatis2
1Department of Orthopaedic Surgery, University of Pennsylvania, Philadelphia, PA.
The Journal of hand surgery
|February 7, 2025
概括
预防性抗生素并没有降低手术手术前的关节或膝关节置换患者的假肢关节感染 (PJI) 率. 这项研究发现,抗生素和非抗生素组之间的PJI发病率没有显著差异.
科学领域:
- 整形外科手术 整形外科手术
- 传染性疾病 传染性疾病
- 药理学 药理学是指药理学的学科.
背景情况:
- 总关节整形术 (TJA) 的患者经常接受各种手术程序.
- 在这些患者进行非关节整形手术后,假肢关节感染 (PJI) 的风险尚未确立.
- 选择性手术是常见的,但其与TJA患者的PJI的关联还未得到充分研究.
研究的目的:
- 调查术后抗生素预防与PJI的发生率之间的关联.
- 为了测试抗生素给药不会影响TJA患者接受选手手术的PJI率的假设.
- 在特定的软组织手术后评估PJI风险.
主要方法:
- 一个大型的国家行政索赔数据库被用来识别接受选手手术的TJA患者.
- 抗生素预防被定义为同一天的IV塞法索林,万科米辛或克林达米辛.
- 倾向性得分匹配和多变量逻辑回归被用来控制混因素,以PJI发病率作为第6,9和12个月的主要结果.
主要成果:
- 在12个月内,PJI的整体发病率为0.8%.
- 在接受预防性抗生素的患者和没有在手术后6,9或12个月接受抗生素的患者之间没有观察到PJI率的显著差异.
- 3个月内手术部位感染与以后的PJI没有相关性.
结论:
- 在手术期间服用抗生素与在患者中PJI的发病率降低不相关,在患者中之前有TJA经历了选择性软组织手术.
- 目前手术的抗生素预防方案可能不需要对TJA患者进行修改.
- 进一步的研究可以探索该人群中PJI的特定风险因素.
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