Stefan Lyutenski, Susanne Wendt, Anja Lieder, Paul James, Marc Bloching
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引用次数: 0
Abstract
Background: There is no consensus in the pertinent literature regarding the optimal antibiotic prophylaxis (AP) for cochlear implantation (CI). This study evaluates the implementation of standardized risk-based AP combined with application of an adhesive film dressing.
Materials and methods: All CI cases since September 2019 were retrospectively reviewed for postoperative wound complications. While all patients received preoperative AP with ceftriaxone, postoperative AP after CI in patients older than 7 years was no longer routinely performed in our clinic. Exceptions were made according to predefined criteria for an increased risk of infection. The wound was covered with a transparent adhesive polyurethane film.
Results: In 72% of the 219 cases, we did not perform postoperative AP. The overall wound complication rate was 2.7% (in the groups with and without postoperative AP, 4.9% and 1.9%, respectively). Wound infection did not occur in any of the patients without postoperative AP older than 70 years (n = 32), with controlled diabetes mellitus (n = 19), or with reimplantation due to technical defect (n = 19). The film did not need to be changed until the suture material was removed.
Conclusion: Standardized risk-based AP can avoid prolonged administration of antibiotics in selected patients. The film dressing permits continual examination and sufficient wound protection.
背景:关于人工耳蜗植入术(CI)的最佳抗生素预防(AP),相关文献尚未达成共识。本研究评估了基于风险的标准化抗生素预防结合胶膜敷料的实施情况:对 2019 年 9 月以来的所有 CI 病例进行了术后伤口并发症回顾性审查。虽然所有患者术前都接受了头孢曲松 AP,但在我们的诊所,7 岁以上患者 CI 术后 AP 已不再是常规操作。根据预先确定的感染风险增加标准,我们将例外处理。伤口用透明的聚氨酯胶膜覆盖:在 219 个病例中,72% 的病例没有进行术后 AP。总体伤口并发症发生率为 2.7%(术后 AP 组和未进行 AP 组的并发症发生率分别为 4.9% 和 1.9%)。在未进行术后 AP 的患者中,年龄超过 70 岁(32 人)、糖尿病得到控制(19 人)或因技术缺陷再次植入(19 人)的患者均未发生伤口感染。结论:结论:基于风险的标准化 AP 可以避免对特定患者长时间使用抗生素。薄膜敷料允许持续检查和充分保护伤口。
期刊介绍:
HNO is an internationally recognized journal and addresses all ENT specialists in practices and clinics dealing with all aspects of ENT medicine, e.g. prevention, diagnostic methods, complication management, modern therapy strategies and surgical procedures.
Review articles provide an overview on selected topics and offer the reader a summary of current findings from all fields of ENT medicine.
Freely submitted original papers allow the presentation of important clinical studies and serve the scientific exchange.
Case reports feature interesting cases and aim at optimizing diagnostic and therapeutic strategies.
Review articles under the rubric ''Continuing Medical Education'' present verified results of scientific research and their integration into daily practice.