Scientific Unit for Clinical and Medical Research, Osijek University Hospital
Abstract
Infekcija rane je i dalje jedna od najčešćih postoperacijskih komplikacija, s posljedičnom produženom hospitalizacijom, dužim oporavkom bolesnika i povećanim troškovima liječenja. Smanjenje incidencije infekcije rane obavlja se na razne načine, uključujući optimalnu preoperativnu pripremu operacijskoga polja, kiruršku tehniku, antibiotsku profilaksu i postoperativno liječenje bolesnika. Iako postoje razni protokoli, optimalna antibiotska profilaksa kod bolesnika s kolorektalnim karcinomom još nije utvrđena. U ovoj studiji smo retrospektivno analizirali bolesnike koji su na našem odjelu operirani radi kolorektalnog karcinoma. Bolesnike smo svrstali ovisno o protokolu antibiotske profilakse u dvije skupine. Skupina A dobivala je gentamicin i metronidazol, a skupina B cefazolin i metronidazol. U obje skupine antibiotska profilaksa započeta je neposredno prije operacije i trajala je 24 sata. Uključeno je 57 bolesnika koji su primali gentamicin i metronidazol te 35 bolesnika koji su primali cefazolin i metronidazol. Učestalost infekcije rane u skupini B bila je 6%, dok je u skupini A, koja je primala gentamicin i metronidazol, bila 24% (p<0,05). Navedeni rezultati upućuju daje kombinacija cefazolina i metronidazola u trajanju od 24 sata učinkovita kao antibiotska profilaksa kod bolesnika s kolorektalnim karcinomom.Surgical site infection remains one of the most frequent postoperative complications, leading to prolonged hospital stay and morbidity as well as increased treatment costs. Efforts to decrease incidence of surgical site infections are various, including improving preoperative skin preparation, surgical technique, antibiotic prophylaxis and postoperative patient management. Optimal antibiotic prophylaxis in colorectal surgery is yet to be determined, although there are various recommended regimes. Patients operated for colorectal cancer at our department were retrospectively analyzed. The patients were grouped according to the antibiotic prophylaxis they received. Earlier group of patients received gentamicin and metronidazole and later group received cefazolin and metronidazole. In both groups antibiotic prophylaxis was initiated immediately before surgery and maintained for 24 hours. 57 patients who received gentamicin and metronidazole and 35 patients who received cefazolin and metronidazole were analyzed. Incidence of surgical site infection in the latter group was 6%, compared with 24% (p<0,05) in the group of patients who received gentamicin and metronidazole. This study indicates that a combination of cefazolin and metronidazole administered for 24 hours is effective as antibiotic prophylaxis in patients undergoing colorectal surgery
