정규 대장수술 후 예방적 항생제의 24시간 사용에 대한 효과

Purpose: Although the two or three-postoperative doses of prophylactic antibiotics are recommended, the tendency for surgeons to prolong the administration of prophylactic antibiotics after colorectal surgery is a well-known fact. The aim of this study was to assess the prophylactic efficacy of two or three-doses of prophylactic antibiotics over a 24 hour period after elective colorectal surgery. Methods: We reviewed the surgical complications in 69 patients who underwent elective colorectal surgery from April to Jun, 2006. All patients had preoperative mechanical bowel cleansing performed. As antibiotic prophylaxis, oral metronidazole was administered 2∼3 times on the day before surgery and second generation cephalosporin were administered intravenously 30 minutes before surgical incision. After surgery, second generation cephalosporin, aminoglycoside and metronidazole were given to all the patients, at 2∼3 doses for 24 hours. Wound conditions were checked on alternate days during the hospital stay and the patients were followed up for at least 30 days after discharge. Results: In 69 patients, the diseases were cancer in 64 cases (92.8%). The procedures were anterior resection or lower anterior resection in 38 cases (55.1%), hemicoloectomy in 16 cases (23.2%), segmental resection in 9 cases, and abdomino-perineal resection or Hartmann’s procedure in 6 cases. The wound complications were wound seroma in 3 cases (4.3%), wound dehiscence in 3 cases (4.3%) and anastomotic leakage in 1 case (1.4%). Conclusion: The wound complication rate was not high after antibiotic prophylaxis for 24 hours in patients who underwent elective colorectal surgery. Further studies are required to establish appropriate guidelines for antibiotic prophylaxis after elective colorectal surgery.