Retrospective study in 1020 cases on the rate of surgical site infections after lacrimal surgery without prophylactic systemic antibiotics

IF 3 3区 医学 Q1 OPHTHALMOLOGY Acta Ophthalmologica Pub Date : 2024-07-02 DOI:10.1111/aos.16735
R. O. B. de Keizer, J. S. Suwandi, J. C. van Limpt, C. Kluis, G. Hötte, A. P. Nagtegaal, D. Paridaens
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Abstract

Background/Aims

Data regarding the effectiveness of prophylactic systemic antibiotics (PSA) in lacrimal surgery is scarce. Therefore, we determined the postoperative surgical site infection (SSI) rate in lacrimal surgery without PSA.

Methods

We retrospectively analysed files of patients who underwent external (extDCR) or endoscopic endonasal dacryocystorhinostomy (endoDCR). We excluded patients with incomplete data (n = 68), acute a priori infection with the need for antibiotics (n = 15) and PSA post-operatively for other reasons (n = 28). Indications for surgery were canalicular stenosis (n = 51, 18.6% endoDCR vs n = 131, 19.5% extDCR), nasolacrimal duct obstruction (n = 118, 43.2% endoDCR vs n = 480, 64.3% extDCR) and mucocele/chronic dacryocystitis (n = 52, 19.0% endoDCR vs n = 187, 25.0% extDCR).

Results

In this study, 1020 DCR surgeries were performed in 899 patients. Postoperative SSI was diagnosed in eight patients (0.8%); exclusively after extDCR (1.1% of all extDCR). No SSIs were found in endoDCR cases. The prevalence between SSI in extDCR versus endoDCR did not prove significant (n = 8/747 0.8% vs n = 0/273 0%, p = 0.13). All patients diagnosed with SSI were successfully treated with systemic oral antibiotics.

Conclusion

The prevalence of SSI after DCR is low and was effectively treated with oral antibiotics. In our study, SSI occurred rarely after extDCR and was not observed after endoDCR. We conclude that lacrimal surgery is safe without the routine administration of PSA.

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对 1020 例泪腺手术后未使用预防性全身抗生素的手术部位感染率进行的回顾性研究。
背景/目的:有关预防性全身抗生素(PSA)在泪道手术中的有效性的数据很少。因此,我们确定了不使用 PSA 的泪道手术的术后手术部位感染(SSI)率:方法:我们回顾性分析了接受体外(extDCR)或内窥镜鼻腔内泪囊鼻腔吻合术(endoDCR)的患者档案。我们排除了资料不全的患者(68 例)、需要使用抗生素的急性先天性感染患者(15 例)和因其他原因导致术后 PSA 的患者(28 例)。手术指征包括管腔狭窄(n = 51,18.6% 的内源性 DCR vs n = 131,19.5% 的外源性 DCR)、鼻泪管阻塞(n = 118,43.2% 的内源性 DCR vs n = 480,64.3% 的外源性 DCR)和粘液囊/慢性泪囊炎(n = 52,19.0% 的内源性 DCR vs n = 187,25.0% 的外源性 DCR):在这项研究中,899 名患者接受了 1020 例 DCR 手术。有 8 名患者(0.8%)被诊断出术后 SSI,且全部发生在根治术后(占所有根治术的 1.1%)。内外科手术病例中未发现 SSI。事实证明,外DCR与内DCR的SSI发生率差异不大(n = 8/747 0.8% vs n = 0/273 0%,p = 0.13)。所有确诊为 SSI 的患者均成功接受了全身口服抗生素治疗:结论:DCR术后SSI发生率较低,口服抗生素可有效治疗。在我们的研究中,外侧泪道手术后很少发生 SSI,内侧泪道手术后也未观察到 SSI。我们的结论是,泪道手术在不常规使用 PSA 的情况下是安全的。
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来源期刊
Acta Ophthalmologica
Acta Ophthalmologica 医学-眼科学
CiteScore
7.60
自引率
5.90%
发文量
433
审稿时长
6 months
期刊介绍: Acta Ophthalmologica is published on behalf of the Acta Ophthalmologica Scandinavica Foundation and is the official scientific publication of the following societies: The Danish Ophthalmological Society, The Finnish Ophthalmological Society, The Icelandic Ophthalmological Society, The Norwegian Ophthalmological Society and The Swedish Ophthalmological Society, and also the European Association for Vision and Eye Research (EVER). Acta Ophthalmologica publishes clinical and experimental original articles, reviews, editorials, educational photo essays (Diagnosis and Therapy in Ophthalmology), case reports and case series, letters to the editor and doctoral theses.
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