[Standardized risk-based antibiotic prophylaxis and adhesive film dressing for the prevention of wound infection following cochlear implantation].

Autor: Lyutenski S; Klinik für Hals‑, Nasen‑, Ohrenheilkunde, Helios Klinikum Berlin-Buch, Schwanebecker Chaussee 50, 13125, Berlin, Deutschland. stefan.lyutenski@helios-gesundheit.de., Wendt S; Klinik für Hals‑, Nasen‑, Ohrenheilkunde, Helios Klinikum Berlin-Buch, Schwanebecker Chaussee 50, 13125, Berlin, Deutschland., Lieder A; Klinik für Hals‑, Nasen‑, Ohrenheilkunde, Helios Klinikum Berlin-Buch, Schwanebecker Chaussee 50, 13125, Berlin, Deutschland., James P; Klinik für Hals‑, Nasen‑, Ohrenheilkunde, Helios Klinikum Berlin-Buch, Schwanebecker Chaussee 50, 13125, Berlin, Deutschland., Bloching M; Klinik für Hals‑, Nasen‑, Ohrenheilkunde, Helios Klinikum Berlin-Buch, Schwanebecker Chaussee 50, 13125, Berlin, Deutschland.
Jazyk: němčina
Zdroj: HNO [HNO] 2024 Jun; Vol. 72 (6), pp. 405-411. Date of Electronic Publication: 2024 Jan 27.
DOI: 10.1007/s00106-024-01423-0
Abstrakt: Background: There is no consensus in the pertinent literature regarding the optimal antibiotic prophylaxis (AP) for cochlear implantation (CI). This study evaluates the implementation of standardized risk-based AP combined with application of an adhesive film dressing.
Materials and Methods: All CI cases since September 2019 were retrospectively reviewed for postoperative wound complications. While all patients received preoperative AP with ceftriaxone, postoperative AP after CI in patients older than 7 years was no longer routinely performed in our clinic. Exceptions were made according to predefined criteria for an increased risk of infection. The wound was covered with a transparent adhesive polyurethane film.
Results: In 72% of the 219 cases, we did not perform postoperative AP. The overall wound complication rate was 2.7% (in the groups with and without postoperative AP, 4.9% and 1.9%, respectively). Wound infection did not occur in any of the patients without postoperative AP older than 70 years (n = 32), with controlled diabetes mellitus (n = 19), or with reimplantation due to technical defect (n = 19). The film did not need to be changed until the suture material was removed.
Conclusion: Standardized risk-based AP can avoid prolonged administration of antibiotics in selected patients. The film dressing permits continual examination and sufficient wound protection.
(© 2024. The Author(s), under exclusive licence to Springer Medizin Verlag GmbH, ein Teil von Springer Nature.)
Databáze: MEDLINE
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