长时间使用抗生素与下肢绕道手术后手术部位感染的减少无关
Hana S Shafique1, Christina L Cui2, Anthony N Eze2
1Duke University School of Medicine, Durham, North Carolina.
The Journal of surgical research
|October 9, 2025
概括
延长24小时以上的抗生素预防并没有减少手术部位感染 (SSI) 在下外围手术后. 这一发现支持抗菌药物管理,将抗生素的使用限制在24小时内,用于下肢旁路手术.
科学领域:
- 血管外科 血管外科
- 预防传染病 预防传染病
- 抗微生物药物管理委员会
背景情况:
- 手术部位感染 (SSI) 是下 inguinal 绕道手术后的一个常见并发症.
- 目前的指导方针建议在不到24小时的时间内进行抗生素预防.
- 关于在下肢旁路 (LEB) 中长时间抗生素有效性的证据有限.
研究的目的:
- 评估长时间抗生素预防时间和术后SSI率之间的关联.
- 在LEB手术后,为临床实践提供有关最佳抗生素持续时间的信息.
主要方法:
- 使用血管质量倡议 (VQI) 数据库 (2014-2023) 的回顾性国家队列研究.
- 包括带有完整的抗生素数据的下内绕道手术.
- 定义标准抗生素持续时间为≤24小时,延长为>24小时.
主要成果:
- 超过21,000项手术,其中2.1%发生了SSI.
- 长时间服用抗生素 (6.6%的病例) 与SSI风险增加有关 (aOR 2.01).
- 糖尿病,ESRD和纵切切口也是SSI风险因素; 赫西丁的使用是保护性的.
结论:
- 长期的外科手术期间抗生素预防并没有减少下内绕道后的SSI.
- 结果支持将抗生素持续时间限制在24小时内,以实现抗菌药物管理.
- 优化抗生素的使用对于预防血管外科手术中的SSI至关重要.
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