Abstract：
OBJECTIVE: 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.
CONCLUSIONS: 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.
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.
CONCLUSIONS: 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.
摘要：
目的：关于预防性系统性抗生素（PSA）在泪道手术中的有效性的数据很少。因此,我们确定了无PSA的泪腺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外部（extDCR）或鼻内镜下泪囊鼻腔吻合术（endoDCR）的患者的文件。我们排除了数据不完整的患者(n=68)，急性先验感染，需要抗生素（n=15）和其他原因（n=28）的术后PSA。手术指征为小管狭窄（n=51，18.6％endoDCRvsn=131，19.5％extDCR），鼻泪管阻塞（n=118，43．2％endoDCRvsn=480，64．3％extDCR）和黏液囊肿/慢性泪囊炎（n=52，19.0％endoDCRvsn=187，25.0％extDCR）。
结果：在这项研究中，在899例患者中进行了1020例DCR手术。8例患者（0.8％）诊断为术后SSI；仅在extDCR后（所有extDCR的1.1％）。在endoDCR病例中未发现SSIs。extDCR与endoDCR中SSI的患病率并不显著(n=8/7470.8%vsn=0/2730%,p=0.13）。所有诊断为SSI的患者均成功接受全身性口服抗生素治疗。
结论：DCR后SSI的患病率较低，口服抗菌药物可有效治疗。在我们的研究中,在extDCR后很少发生SSI，在endoDCR后未观察到。我们得出的结论是，在没有常规PSA给药的情况下，泪道手术是安全的。
方法：我们回顾性分析了接受外部（extDCR）或鼻内镜下泪囊鼻腔吻合术（endoDCR）的患者的文件。我们排除了数据不完整的患者(n=68)，急性先验感染，需要抗生素（n=15）和其他原因（n=28）的术后PSA。手术指征为小管狭窄（n=51，18.6％endoDCRvsn=131，19.5％extDCR），鼻泪管阻塞（n=118，43．2％endoDCRvsn=480，64．3％extDCR）和黏液囊肿/慢性泪囊炎（n=52，19.0％endoDCRvsn=187，25.0％extDCR）。
结果：在这项研究中，在899例患者中进行了1020例DCR手术。8例患者（0.8％）诊断为术后SSI；仅在extDCR后（所有extDCR的1.1％）。在endoDCR病例中未发现SSIs。extDCR与endoDCR中SSI的患病率并不显著(n=8/7470.8%vsn=0/2730%,p=0.13）。所有诊断为SSI的患者均成功接受全身性口服抗生素治疗。
结论：DCR后SSI的患病率较低，口服抗菌药物可有效治疗。在我们的研究中,在extDCR后很少发生SSI，在endoDCR后未观察到。我们得出的结论是，在没有常规PSA给药的情况下，泪道手术是安全的。
