在手术抗生素预防中使用和机构变化,用于儿科清洁 (I类) 阴茎和沟手术
Brendan T Frainey1, Isabella Zaniletti2, Leslie M Peard3
1Department of Urology, Division of Pediatric Urology, Monroe Carell Jr. Children's Hospital at Vanderbilt, Vanderbilt University Medical Center, Nashville, TN, USA.
Journal of pediatric urology
|May 24, 2025
概括
手术抗生素预防 (SAP) 在14%的儿科泌尿外科手术中使用,尽管有针对清洁伤口的指导方针. 根据医院和手术类型,使用情况有很大差异,这表明需要标准化的抗菌药物管理.
科学领域:
- 儿科泌尿外科 儿科泌尿外科
- 外科手术的结果
- 抗微生物药物管理委员会
背景情况:
- 门诊儿科的阴茎, inguinal 和阴囊手术通常是干净的 (I类) 手术伤口.
- 在这些低风险病例中,指导方针一般不建议进行手术抗生素预防 (SAP).
- 有限的数据存在SAP利用和结果在儿科泌尿病学.
研究的目的:
- 评估国家和医院一级的SAP用于常见的,低风险的门诊儿科泌尿外科手术的使用情况.
- 在这些程序中识别与SAP使用相关的因素.
- 评估与SAP使用相关的二次结果.
主要方法:
- 从2016年到2023年对儿科健康信息系统 (PHIS) 数据库的分析.
- 包括29天至18岁的男性接受门诊阴茎和/或沟手术.
- 多变量后勤回归与一般化的估计方程,以确定与SAP使用相关的因素,并比较结果.
主要成果:
- 分析了108,419个程序;14%的人接受了SAP.
- 膝关节手术 (19%) 的SAP使用率高于阴茎手术 (8%).
- 与增加SAP使用相关的因素包括沟手术,年龄较大和泌尿科医生作为手术医生;二级结果在各组之间是相似的.
结论:
- 在不复杂的儿科泌尿外科手术中,SAP的使用率仍然高达14%,医院间的差异很大.
- 关手术,老年患者和泌尿科医生进行手术与更高的SAP率有关.
- 需要对SAP实践进行标准化,以平衡SSI预防与抗菌药物管理.
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