Wide variation in risk of wound infection following clean neurosurgery. Implications for perioperative antibiotic prophylaxis.
Wide variation in risk of wound infection following clean neurosurgery. Implications for perioperative antibiotic prophylaxis.
复制标题
清洁神经外科手术后伤口感染的风险差异很大。
作者：
J. Tenney;D. Vlahov;M. Salcman;T. B. Ducker
作者对936例患者的清洁神经外科术后伤口感染的发生率进行了前瞻性研究。不到1%的患者接受了围手术期抗生素预防。深部伤口感染的总体发生率为2.6%;没有死亡直接归因于这些感染。开颅手术后深部伤口感染的发生率（4.3%）显著高于脊柱手术（0.9%）或其他清洁神经外科手术。在开颅手术中，深部伤口感染率从复发性胶质瘤重复手术后的11%到非肿瘤手术后的2.5%有显著差异。根据清洁神经外科手术的类型，深度伤口感染的风险变化超过11倍。在术后伤口感染风险最大的清洁神经外科手术中，证明围手术期抗生素的潜在有效性是最可行的。对于接受这些高风险手术的患者，这种预防的潜在益处最大。
The authors have prospectively examined the occurrence of postoperative wound infection following clean neurosurgery in 936 patients. Fewer than 1% received perioperative antibiotic prophylaxis. The overall rate of deep wound infection was 2.6%; no deaths were directly attributable to these infections. Deep wound infections occurred significantly more frequently following craniotomy (4.3%) than following spinal (0.9%) or other clean neurosurgery. Among craniotomies, the deep wound infection rate varied significantly from 11% following repeat operations for recurrent gliomas to 2.5% following non-tumor surgery. Risk of deep wound infection varied more than 11-fold depending on the type of clean neurosurgical operation. It is most feasible to demonstrate the potential efficacy of perioperative antibiotics in clean neurosurgical procedures with the greatest risk of postoperative wound infection. The potential benefit from such prophylaxis would be greatest for patients undergoing these high-risk operations.