Duration of Perioperative Antibiotic Use for Open Nissen Fundoplication

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  • 開腹噴門形成術における予防的抗菌薬の投与期間についての検討
  • カイフク フンモン ケイセイジュツ ニ オケル ヨボウテキ コウキンヤク ノ トウヨ キカン ニ ツイテ ノ ケントウ

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Purpose: The ideal perioperative antibiotic use for preventing surgical site infection (SSI) in children is not clearly defined. We reviewed our patients who underwent open Nissen fundoplication with gastrostomy to elucidate the optimal duration of antibiotic therapy after operation.<br>Methods: Between January 2009 and December 2011, 44 neurologically impaired patients who underwent Nissen fundoplication with gastrostomy by laparotomy were examined. The preoperative nutritional status (serum total protein: TP and Albumin: Alb), number of methicillin-resistant Staphylococcus aureus (MRSA) carriers, heart disease and tracheostomy, and the incidence of SSI in each group were evaluated.<br>Results: The number of patients (n) for each of three groups were divided according to the duration of perioperative antibiotic use: Groups A (n:19; 3–6 days); B (n-13; 2 days); and Group C (n=12; 1 day). Antibiotic cefazolin (CEZ) or piperacillin (PIPC) was intravenously administered 30 minutes before the incision was made in all patients. The same dose of antibiotic was intravenously administered every 8 hours postoperatively. There was no statistically significant difference in the three groups in patient profiles, except for the number of tracheostomies. The incidence of SSI was not statistically different between the three groups (10.5% vs 0% vs 0%).<br>Conclusion: One-day use of antimicrobial prophylaxis was sufficient to prevent SSI in patients who underwent open Nissen fundoplication with gastrostomy.

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