手术部位感染(SSIs)仍然是外科领域的重要问题,导致患者发病率,住院时间延长,增加医疗费用。抗生素预防,手术前使用抗生素,几十年来一直是预防SSIs的基石。这篇综述探讨了手术中抗生素预防的现状,提供对其有效性的见解,挑战,和新兴趋势。在这种综合分析中,我们深入研究抗生素预防的历史发展,研究其从早期实践到现代准则的演变。我们探索常用的各类抗生素,他们的给药方案,以及优化预防性干预措施时机的重要性。此外,我们调查了患者特定因素的作用,如合并症和过敏,根据个人需要定制抗生素预防。虽然抗生素预防不可否认地降低了SSIs的发病率,对抗菌素耐药性和不良反应的担忧需要重新评估当前的做法。这篇综述对手术中过度使用和滥用抗生素所带来的挑战进行了严格的评估,并强调了对明智的抗生素管理的迫切需要。此外,随着抗菌涂料等创新战略的出现,抗生素预防的未来有望实现,益生菌,和免疫调节剂。我们讨论了这些新方法及其在增强SSI预防同时将抗生素相关风险降至最低的潜力。总之,手术中的抗生素预防一直有助于减少SSIs,但是它的持续有效性需要多方面的方法。通过应对当前的挑战,促进抗生素管理,拥抱创新战略,我们可以在未来几年推进SSI预防领域并改善患者预后。这篇综述为临床医生提供了有价值的见解和方向,研究人员,和政策制定者在外科预防的不断发展的格局中导航。
Surgical site infections (SSIs) remain a significant concern in the field of surgery, contributing to patient morbidity, prolonged hospital stays, and increased healthcare costs. Antibiotic prophylaxis, the administration of antibiotics before surgery, has been a cornerstone in preventing SSIs for decades. This review explores the current state of antibiotic prophylaxis in surgery, offering insights into its effectiveness, challenges, and emerging trends. In this comprehensive analysis, we delve into the historical development of antibiotic prophylaxis, examining its evolution from early practices to modern guidelines. We explore the various classes of antibiotics commonly used, their dosing regimens, and the importance of timing in optimizing prophylactic interventions. Additionally, we investigate the role of patient-specific factors, such as comorbidities and allergies, in tailoring antibiotic prophylaxis to individual needs. While antibiotic prophylaxis has undeniably reduced the incidence of SSIs, concerns about antimicrobial resistance and adverse effects necessitate a reevaluation of current practices. This review presents a critical assessment of the challenges posed by the overuse and misuse of antibiotics in surgery and highlights the urgent need for judicious antibiotic stewardship. Moreover, the future of antibiotic prophylaxis holds promise with the emergence of innovative strategies such as antimicrobial coatings, probiotics, and immunomodulatory agents. We discuss these novel approaches and their potential to enhance SSI prevention while minimizing antibiotic-related risks. In conclusion, antibiotic prophylaxis in surgery has been instrumental in reducing SSIs, but its continued effectiveness requires a multifaceted approach. By addressing current challenges, promoting antibiotic stewardship, and embracing innovative strategies, we can advance the field of SSI prevention and improve patient outcomes in the years to come. This review provides valuable insights and direction for clinicians, researchers, and policymakers as they navigate the evolving landscape of surgical prophylaxis.