术后抗生素对下颌骨放射性骨坏死节段性切除及微血管重建的影响。

IF 2.2 3区医学 Q1 OTORHINOLARYNGOLOGY

Head and Neck-Journal for the Sciences and Specialties of the Head and Neck Pub Date : 2025-07-07 DOI:10.1002/hed.28235

Marta M Williams, Francis X Creighton, Miriam B Barshak, Jeremy D Richmon, Derrick T Lin, Daniel G Deschler, Kevin S Emerick, Mark A Varvares, Marlene L Durand

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引用次数: 0

摘要

背景：下颌骨放射性骨坏死（ORN）手术治疗后最佳静脉注射（IV）抗生素方案尚不清楚。本研究评估了培养导向IV抗生素（基于术中培养）对早期伤口并发症的影响，包括手术部位感染（ssi）和抗生素持续时间对伤口长期愈合（愈合≤2个月无后续并发症）的影响。方法：回顾性分析2009-2022年，N = 44例，游离皮瓣占70%，带蒂皮瓣占30%。结果：术后抗生素为培养型（25例）或经验型（19例）；培养指导组SSI发生率较低（0% vs. 26.3%, p = 0.01）。22例患者术后接受短疗程（平均9天）和长疗程（平均43天）静脉注射抗生素。在随访期间（平均5.7年），这些组的长期伤口愈合率相似（50%对36%，p = 0.54）。结论：在本研究中，术后接受定向培养静脉注射抗生素的患者无ssi。长期伤口愈合率不受抗生素持续时间的影响。

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The Impact of Postoperative Antibiotics on Outcomes Following Segmental Resection and Microvascular Reconstruction for Mandibular Osteoradionecrosis.

Background: The optimal intravenous (IV) antibiotic regimen following definitive surgical treatment for mandibular osteoradionecrosis (ORN) is unknown. This study evaluated the effect of culture-directed IV antibiotics (based on intraoperative cultures) on early wound complications, including surgical site infections (SSIs) and antibiotic duration on long-term wound healing (healing ≤ 2 months without subsequent complications).

Methods: Retrospective review of flap reconstruction for ORN (2009-2022, N = 44, 70% free flaps, 30% pedicled).

Results: Postoperative antibiotics were culture-directed (25 patients) or empiric (19); the SSI rate was lower in the culture-directed group (0% vs. 26.3%, p = 0.01). Twenty-two patients received short-course (mean 9 days) and 22 long-course (mean 43 days) IV antibiotics postoperatively. During follow-up (mean 5.7 years), these groups had similar rates of long-term wound healing (50% vs. 36%, p = 0.54).

Conclusion: In this series, patients who received culture-directed IV antibiotics postoperatively had zero SSIs. The rate of long-term wound healing was not affected by the antibiotic duration.

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来源期刊

Head and Neck-Journal for the Sciences and Specialties of the Head and Neck 医学-耳鼻喉科学

CiteScore

7.00

自引率

6.90%

发文量

278

审稿时长

1.6 months

期刊介绍： Head & Neck is an international multidisciplinary publication of original contributions concerning the diagnosis and management of diseases of the head and neck. This area involves the overlapping interests and expertise of several surgical and medical specialties, including general surgery, neurosurgery, otolaryngology, plastic surgery, oral surgery, dermatology, ophthalmology, pathology, radiotherapy, medical oncology, and the corresponding basic sciences.