Five day antibiotic prophylaxis for major lower limb amputation reduces wound infection rates and the length of in-hospital stay.
作者： U. Sadat , A. Chaudhuri , P.D. Hayes , M.E. Gaunt , J.R. Boyle
DOI: 10.1016/J.EJVS.2007.07.016
关键词: Amputation 、 Anesthesia 、 Vancomycin 、 Retrospective cohort study 、 Antibiotic prophylaxis 、 Medicine 、 Metronidazole 、 Prospective cohort study 、 Flucloxacillin 、 Antibiotics 、 Surgery
摘要: Objective To compare wound infection, revision rates and hospital stay after major lower limb amputation between patients receiving 24 hours versus 5 days of prophylactic antibiotics. Methods The outcomes a consecutive series 40 amputations in short 24-hour course combined antibiotics (flucloxacillin/vancomycin + gentamicin/ciproxin metronidazole) were retrospectively analysed. Following this further group studied prospectively following the institution 5-day regime using same Results 2 groups similar terms demographics, vascular risk factors level amputation. antibiotic led to significant reduction infection (5% vs. 22.5%, P = 0.023) reduced length (22 34 days, P = 0.001). Revision (2.5% 10%) but did not reach statistical significance (P = 0.36). More prospective operated on by trainee. (77.5% 55% P = 0.033). Conclusions This data supports use prolonged appears reduce stump leading shorter in-hospital stay.
core.ac.uk
elsevier.com
sci-hub.se 参考文章(10)
G. S. Makin, J. J. Earnshaw, B. R. Hopkinson, R. C. Slack, Risk factors in vascular surgical sepsis. Annals of The Royal College of Surgeons of England. ,vol. 70, pp. 139- 143 ,(1988)
John C. Hall, Keryn J. Christiansen, Marcel Goodman, Michael Lawrence-Brown, Francis J. Prendergast, Peta Rosenberg, Briony Mills, Jane L. Hall, Duration of antimicrobial prophylaxis in vascular surgery The American Journal of Surgery. ,vol. 175, pp. 87- 90 ,(1998) , 10.1016/S0002-9610(97)00270-5
D.C. Berridge, R.C.B. Slack, B.R. Hopkinson, G.S. Makin, A bacteriological survey of amputation wound sepsis Journal of Hospital Infection. ,vol. 13, pp. 167- 172 ,(1989) , 10.1016/0195-6701(89)90023-6
Stephan Harbarth, Matthew H. Samore, Debi Lichtenberg, Yehuda Carmeli, Prolonged Antibiotic Prophylaxis After Cardiovascular Surgery and Its Effect on Surgical Site Infections and Antimicrobial Resistance Circulation. ,vol. 101, pp. 2916- 2921 ,(2000) , 10.1161/01.CIR.101.25.2916
Dale W. Bratzler, Peter M. Houck, Antimicrobial prophylaxis for surgery: An advisory statement from the National Surgical Infection Prevention Project American Journal of Surgery. ,vol. 189, pp. 395- 404 ,(2005) , 10.1016/J.AMJSURG.2005.01.015
H. Friis, Penicillin G versus cefuroxime for prophylaxis in lower limb amputation Acta Orthopaedica Scandinavica. ,vol. 58, pp. 666- 668 ,(1987) , 10.3109/17453678709146511
Philip S. Barie, Soumitra R. Eachempati, Surgical Site Infections Surgical Clinics of North America. ,vol. 85, pp. 1115- 1135 ,(2005) , 10.1016/J.SUC.2005.09.006
R. B. Galland, A. A. Pittathankel, T. R. Magee, R. Pursell, Toby Richards, MRSA in lower limb amputation and the role of antibiotic prophylaxis Journal of Cardiovascular Surgery. ,vol. 46, pp. 37- 41 ,(2005)
N. A. Kritzinger, W. K. J. Huizinga, J. V. Robbs, Prevention of wound sepsis in amputations by peri-operative antibiotic cover with an amoxycillin-clavulanic acid combination. South African Medical Journal. ,vol. 63, pp. 71- 73 ,(1983)
R.L. Nichols, Antibiotic Prophylaxis in Surgery Journal of Chemotherapy. ,vol. 1, pp. 170- 178 ,(1989) , 10.1080/1120009X.1989.11738887