背景：国际指南建议对主要闭合手术切口使用预防性抗菌药物，但是大多数眼整形外科医生报告说使用氯霉素软膏。我们评估了接受眼睑手术的患者术后预防性氯霉素软膏的基线手术部位感染率（SSI）。然后对预防措施的撤回进行前瞻性审核，以确定感染率是否以临床意义的方式发生变化。这篇文章报道了早期的发现。患者和方法：进行了单中心回顾性审核；对连续接受初次切口闭合眼睑手术的患者进行了电子病历审查。所有患者均接受术后预防性氯霉素治疗。那些有组织病理学证据的恶性肿瘤被排除在外。患者人口统计学，手术细节,记录术后SSI和其他并发症的证据.根据国家指南改变了当地政策；预防性氯霉素软膏被扣留，以及预期收集的上述信息。我们的政策排除了皮肤恶性肿瘤,全厚度皮肤移植物，全身免疫抑制患者，和糖尿病，因为潜在的感染风险增加。结果:组间差异无统计学意义,除了外科医生的资历。手术部位感染在接受术后氯霉素治疗的872只眼中有14只（1.6％），133只眼睛中有3只(2.25%)没有使用抗生素，这没有统计学意义。结论：眼睑手术术后SSI发生率较低。在主要闭合的手术眼睑切口中常规使用预防性抗生素不符合国际标准，并且可能导致抗生素耐药性。早期结果表明，如果没有预防性氯霉素，感染率仍然很低；临床医生应考虑将其从合适患者的常规实践中撤出。
Background: International
guidelines advise against prophylactic antimicrobial agents for primarily closed surgical incisions, but most oculoplastic surgeons report using chloramphenicol ointment. We evaluated baseline surgical site infection (SSI) rates in patients undergoing eyelid surgery who received prophylactic chloramphenicol ointment post-operatively. Withdrawal of prophylaxis was then prospectively audited to establish whether infection rates changed in a clinically meaningful way. This article reports the early findings. Patients and Methods: A single-center retrospective audit was undertaken; electronic medical records were reviewed for consecutive patients who underwent eyelid surgery with primary incision closure. All patients received post-operative prophylactic chloramphenicol. Those with histopathologic evidence of malignancy were excluded. Patient demographics, surgical details, evidence of post-operative SSI and other complications were recorded. Local policy was changed in accordance with national
guidelines; prophylactic chloramphenicol ointment was withheld, and the above information collected prospectively. Our policy excluded skin malignancies, full thickness skin grafts, patients on systemic immunosuppression, and diabetes mellitus because of potential increased infection risk. Results: There were no statistically significant differences between the groups, except seniority of surgeon. Surgical site infection was identified in 14 of 872 eyes (1.6%) receiving post-operative chloramphenicol, and three of 133 eyes (2.25%) without antibiotic agents, which was not statistically significant. Conclusions: Post-operative SSI rates in eyelid surgery are low. Routine use of prophylactic antibiotic agents in primarily closed surgical eyelid incisions does not adhere to international standards and may contribute to antimicrobial resistance. Early results suggest infection rates remain low without prophylactic chloramphenicol; clinicians should consider withdrawing it from routine practice in suitable patients.
