Kadri ÖZER, Özlem ÇOLAK, Yüksel KANKAYA, Uğur KOÇER, Koray GÜRSOY, Adile DİKMEN, Emel ANAYURT

KARPAL TÜNEL CERRAHİSİNDE PERİOPERATİF ANTİBİYOTİK PROFİLAKSİSİNİN ROLÜ: PROSPEKTİF, RANDOMİZE, KONTROLLÜ, ÇİFT-KÖR BİR ÇALIŞMA

AMAÇ: El cerrahisinde antibiyotik profilaksisi tartışmalı olarak kalmıştır. Bazı yazarlar bu tartışmalı durumun değişken yüzeysel ve derin cerrahi alan enfeksiyonları tanımları, randomize kontrollü çalışmaların eksikliği ve istatistiksel testlerin zorluğu nedeniyle var olduğunu ileri sürmüşlerdir. Bu yazıda elektif bir el cerrahi operasyonu olan karpal tünel serbestlemesi cerrahisinde antibiyotik profilaksisinin gerekliliğini değerlendirmek için prospektif, randomize, kontrollü, çift kör bir çalışma yaptık. GEREÇ VE YÖNTEMLER: Tüm hastalara operasyon öncesi 30.dakikada, operasyon sonrası 60.dakikada ve 24.saatte 10 ml.lik ne olduğu hakkında sadece şef hemşirenin E.A. bilgisi olduğu sadece %0.9 NaCl veya 1 g sefazolin içeren %0.9 NaCl olan enjeksiyonlar toplam üç doz olarak yapıldı. Grup 1 n=10 , tek doz profilaksi grubu; Grup 2 n=10 , iki doz profilaksi grubu; Grup 3 n=10 , üç doz profilaksi grubu ve Grup 4 n=10 , profilaksi almayan grup olarak tanımlandı. Çalışma sonlanana kadar, hastalar ve cerrahlar hangi grupta hangi hasta olduklarına dair bir bilgiye sahip değillerdi. Hastalar, postoperatif 1,2,3,5,7,10,14,30. günlerde yara yeri olarak Centers for Disease Control and Prevention CDC cerrahi alan enfeksiyonu kılavuzlarına göre değerlendirildi. BULGULAR: Sonuç olarak, sadece bir cerrahi alan enfeksiyonu Grup 4’te tanımlandı; fakat gruplar arasında herhangi bir istatistiksel fark izlenmedi p>0.05 .SONUÇ: Perioperatif antibiyotik profilaksisinin karpal tünel cerrahisinde cerrahi alan enfeksiyon oranlarını azaltmadığı sonucuna varabilmekteyiz

Anahtar Kelimeler:

Karpal tünel sendromu, profilaksi, antibiyotik

THE ROLE OF PERIOPERATIVE ANTIBIOTICS PROPHYLAXIS IN CARPAL TUNNEL SURGERY: A PROSPECTIVE, RANDOMIZED, CONTROLLED, TWO-BLINDED STUDY

OBJECTIVE: The role of antibiotic prophylaxis in hand surgery remains controversial. Some authors have suggested that this controversy exists because of varying definitions of superficial and deep surgical site infections, lack of randomized, controlled trials, and difficulty in statistical testing. In this report, we performed a prospective, randomized, controlled, two-blinded study to evaluate the need of the antibiotic prophylaxis in carpal tunnel release surgery as an elective hand surgery operation.MATERIAL AND METHODS: Totally three dosages of 10 ml intravenous injections were administered to all patients in 30 minutes before the operation, 60 minutes and 24 hours after the operation in which including only 0.9% NaCl solution or 0.9% NaCl solution including 1 g cefazoline which the only chief nurse E.A. had a knowledge about. Group 1 n = 10 was defined as single dose of prophylaxis group; whereas Group 2 n = 10 as two doses of prophylaxis group; Group 3 n = 10 , as three doses of prophylaxis group and Group 4 n = 10 as the group receiving no prophylaxis. Until the end of the study, patients and surgeons had no knowledge about which patient was in which group. The patients were evaluated on postoperative 1,2,3,5,7,10,14,30 days for the wound according to Centers for Disease Control and Prevention CDC terms for the surgical site infection guidelines.RESULTS: As a result, only one surgical site infection was defined in Group 4; however there was no statistical difference between the groups p>0.05 .CONCLUSION: We may conclude that perioperative antibiotics prophylaxis did not decrease the rate of surgical site infection in carpal tunnel surgery

Keywords:

Carpal tunnel syndrome, prophylaxis, antibiotics,

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