新生儿手术围手术期抗生素预防的持续时间：少即是多。

IF 2.7 3区医学 Q1 SURGERY

American journal of surgery Pub Date : 2024-08-15 DOI:10.1016/j.amjsurg.2024.115901

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引用次数: 0

摘要

背景：新生儿抗生素预防的理想持续时间尚未确定，实践中的差异很大。本研究旨在评估新生儿手术中抗生素使用时间与手术部位感染（SSI）之间的关系：结果：19/155 例患者发生了 SSI：19/155例患者发生了SSI（12.26%）。出现 SSI 的患者手术时体重较轻（p = 0.03）。此外，伤口分类（p = 0.17）和抗生素使用时间大于 48 小时（p = 0.94）在 SSI 感染率上没有统计学差异。与 SSI 发生最密切相关的两个变量是胎龄（100%）和手术时的体重（80.76%）：结论：抗生素预防时间超过 48 小时并不能降低 SSI 的发生率。新生儿手术中出现 SSI 的风险因素是较低的胎龄、手术时体重下降和手术总时长。

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Duration of perioperative antibiotic prophylaxis in neonatal surgery: Less is more

Background

The ideal duration of neonatal antibiotic prophylaxis is not determined with wide variance in practice. This study aims to evaluate the association between duration of antibiotics and surgical site infection (SSI) in neonatal surgery.

Methods

A retrospective review regarding antibiotic prophylaxis was performed on <30-day-old surgical patients at a children's hospital from 2014 to 2019. The patients were analyzed based on demographics, presence of SSI, and antibiotic duration. The primary outcome was the development of SSI with ANOVA, chi-square, and recursive partitioning used for statistical analysis.

Results

19/155 patients developed an SSI (12.26 %). Those with an SSI had a lower weight at surgery (p = 0.03). Additionally, wound classification (p = 0.17) and antibiotic duration >48hrs (p = 0.94) made no statistical difference in SSI rate. The two variables most closely linked to SSI development were gestational age (100 %) and weight at time of procedure (80.76 %).

Conclusions

Antibiotic prophylaxis >48 h did not decrease the incidence of SSI. Risk factors for SSI development in neonatal surgery were lower gestational age, decreased weight at time of procedure and total length of procedure.

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来源期刊

American journal of surgery 医学-外科

CiteScore

5.00

自引率

6.70%

发文量

570

审稿时长

56 days

期刊介绍： The American Journal of Surgery® is a peer-reviewed journal designed for the general surgeon who performs abdominal, cancer, vascular, head and neck, breast, colorectal, and other forms of surgery. AJS is the official journal of 7 major surgical societies* and publishes their official papers as well as independently submitted clinical studies, editorials, reviews, brief reports, correspondence and book reviews.