PDF(Pubmed)
Abstract：
BACKGROUND: The purpose of this analysis was to investigate the most appropriate duration of postoperative antibiotic treatment to minimize the incidence of intraabdominal abscesses and wound infections in patients with complicated appendicitis.
METHODS: In this retrospective study, which included 396 adult patients who underwent appendectomy for complicated appendicitis between January 2010 and December 2020 at the University Hospital Erlangen, patients were classified into two groups based on the duration of their postoperative antibiotic intake: ≤ 3 postoperative days (group 1) vs. ≥ 4 postoperative days (group 2). The incidence of postoperative intraabdominal abscesses and wound infections were compared between the groups. Additionally, multivariate risk factor analysis for the occurrence of intraabdominal abscesses and wound infections was performed.
RESULTS: The two groups contained 226 and 170 patients, respectively. The incidence of postoperative intraabdominal abscesses (2% vs. 3%, p = 0.507) and wound infections (3% vs. 6%, p = 0.080) did not differ significantly between the groups. Multivariate analysis revealed that an additional cecum resection (OR 5.5 (95% CI 1.4-21.5), p = 0.014) was an independent risk factor for intraabdominal abscesses. A higher BMI (OR 5.9 (95% CI 1.2-29.2), p = 0.030) and conversion to an open procedure (OR 5.2 (95% CI 1.4-20.0), p = 0.016) were identified as independent risk factors for wound infections.
CONCLUSIONS: The duration of postoperative antibiotic therapy does not appear to influence the incidence of postoperative intraabdominal abscesses and wound infections. Therefore, short-term postoperative antibiotic treatment should be preferred.
METHODS: In this retrospective study, which included 396 adult patients who underwent appendectomy for complicated appendicitis between January 2010 and December 2020 at the University Hospital Erlangen, patients were classified into two groups based on the duration of their postoperative antibiotic intake: ≤ 3 postoperative days (group 1) vs. ≥ 4 postoperative days (group 2). The incidence of postoperative intraabdominal abscesses and wound infections were compared between the groups. Additionally, multivariate risk factor analysis for the occurrence of intraabdominal abscesses and wound infections was performed.
RESULTS: The two groups contained 226 and 170 patients, respectively. The incidence of postoperative intraabdominal abscesses (2% vs. 3%, p = 0.507) and wound infections (3% vs. 6%, p = 0.080) did not differ significantly between the groups. Multivariate analysis revealed that an additional cecum resection (OR 5.5 (95% CI 1.4-21.5), p = 0.014) was an independent risk factor for intraabdominal abscesses. A higher BMI (OR 5.9 (95% CI 1.2-29.2), p = 0.030) and conversion to an open procedure (OR 5.2 (95% CI 1.4-20.0), p = 0.016) were identified as independent risk factors for wound infections.
CONCLUSIONS: The duration of postoperative antibiotic therapy does not appear to influence the incidence of postoperative intraabdominal abscesses and wound infections. Therefore, short-term postoperative antibiotic treatment should be preferred.
摘要：
背景：本分析的目的是研究术后抗生素治疗的最合适持续时间，以最大程度地减少复杂性阑尾炎患者腹腔脓肿和伤口感染的发生率。
方法：在这项回顾性研究中，其中包括2010年1月至2020年12月在埃尔兰根大学医院接受复杂性阑尾炎阑尾切除术的396名成年患者，根据术后抗生素摄入量的持续时间将患者分为两组：≤术后3天（第1组）与术后≥4天（第2组）。比较两组患者术后腹腔脓肿和切口感染的发生率。此外,对腹腔脓肿和伤口感染的发生进行了多因素危险因素分析。
结果：两组共226和170名患者，分别。术后腹腔脓肿的发生率(2%vs.3%,p=0.507）和伤口感染（3%vs.6%,p=0.080）在两组之间没有显着差异。多变量分析显示，另一次盲肠切除(OR5.5(95%CI1.4-21.5)，p=0.014）是腹腔脓肿的独立危险因素。BMI较高（OR5.9（95%CI1.2-29.2），p=0.030)并转换为开放程序(OR5.2(95%CI1.4-20.0)，p=0.016）被确定为伤口感染的独立危险因素。
结论：术后抗生素治疗的持续时间似乎不影响术后腹腔脓肿和伤口感染的发生率。因此,应首选术后短期抗生素治疗。
方法：在这项回顾性研究中，其中包括2010年1月至2020年12月在埃尔兰根大学医院接受复杂性阑尾炎阑尾切除术的396名成年患者，根据术后抗生素摄入量的持续时间将患者分为两组：≤术后3天（第1组）与术后≥4天（第2组）。比较两组患者术后腹腔脓肿和切口感染的发生率。此外,对腹腔脓肿和伤口感染的发生进行了多因素危险因素分析。
结果：两组共226和170名患者，分别。术后腹腔脓肿的发生率(2%vs.3%,p=0.507）和伤口感染（3%vs.6%,p=0.080）在两组之间没有显着差异。多变量分析显示，另一次盲肠切除(OR5.5(95%CI1.4-21.5)，p=0.014）是腹腔脓肿的独立危险因素。BMI较高（OR5.9（95%CI1.2-29.2），p=0.030)并转换为开放程序(OR5.2(95%CI1.4-20.0)，p=0.016）被确定为伤口感染的独立危险因素。
结论：术后抗生素治疗的持续时间似乎不影响术后腹腔脓肿和伤口感染的发生率。因此,应首选术后短期抗生素治疗。
