减少乳房成形术是一个公认的程序。研究表明,在此过程中使用抗生素的好处。然而,没有确凿的证据支持术后预防使用抗生素.作者评估了术后抗生素分娩对乳房缩小成形术后感染率的影响。
作者进行了一项关于非劣效性的随机试验,有两个平行的组,三重致盲。参与者是124名乳房肥大的女性,已经安排了减少乳房成形术,连续选择。所有患者均行乳房缩小成形术,由同一个手术团队执行,使用超内侧椎弓根技术提升乳头乳晕复合体。所有患者在麻醉诱导时静脉注射头孢菌素(1g),每6小时一次,持续24小时。出院时,他们被随机分配到安慰剂组(n=62)或抗生素组(n=62),并被指示服用含有500毫克头孢氨苄或安慰剂的相同胶囊,分别,每6小时,7天。每周对患者进行评估,4周,关于手术部位感染的发生,一位不知道分配的外科医生。通过了疾病控制和预防中心的标准和定义。
两组之间的年龄没有统计学差异,身体质量指数,或切除的乳房组织重量。手术部位总感染率为0.81%。只有一个病人,分配给抗生素,呈现感染,分类为浅表切口(p=1.00)。在安慰剂组中,手术时间更长(p=0.003).
在隆乳术后期间维持抗生素并不影响手术部位感染率。
治疗,I.
Reduction mammaplasty is a well-established procedure. Studies have shown benefits of using antibiotics in this procedure. Nevertheless, there is no solid evidence to support postoperative antibiotic prophylaxis. The authors evaluated the influence of postoperative antibiotic delivery on infection rates after reduction mammaplasty.
The authors conducted a randomized
trial of noninferiority, with two parallel groups, with triple blinding. The participants were 124 women with breast hypertrophy, with reduction mammaplasty already scheduled, selected consecutively. All patients underwent reduction mammaplasty, performed by the same surgical team, using the superomedial pedicle technique for ascending the nipple-areola complex. All patients received
cephalothin (1 g) intravenously at the anesthetic induction and every 6 hours for 24 hours. At hospital discharge, they were assigned randomly to either the placebo (n = 62) or antibiotic group (n = 62) and were instructed to take identical capsules containing 500 mg of cephalexin or placebo, respectively, every 6 hours, for 7 days. Patients were assessed weekly, for 4 weeks, regarding the occurrence of surgical-site infection, by a surgeon who was unaware of the allocation. The criteria and definitions of the Centers for Disease Control and Prevention were adopted.
There was no statistical difference between groups regarding age, body mass index, or resected breast tissue weight. The overall surgical-site infection rate was 0.81 percent. Only one patient, allocated to the antibiotic, presented infection, classified as superficial incisional (p = 1.00). In the placebo group, surgery time was higher (p = 0.003).
The maintenance of antibiotics in the postoperative period of reduction mammaplasty did not influence the rates of surgical-site infection.
Therapeutic, I.