全腹腔鏡下子宮全摘術の術後手術部位感染（SSI：Surgical Site Infection）減少を目指した周術期抗菌薬の検討

抄録

　Total laparoscopic hysterectomy (TLH) was introduced in our hospital in December 2018. A total of 145 patients underwent the procedure by April 2022, and five of them developed surgical site infection (SSI). After excluding one patient with laparotomy conversion and one with suspected beta-lactam allergy, 143 patients were categorized into the following three groups according to the type of perioperative antimicrobial prophylaxis, with the goal of retrospectively comparing patient characteristics and the incidence of SSI: 1) a single administration of 1 g flomoxef sodium (FMOX) (FMOX-A group, n=37), 2) a single administration of 1 g cefazolin (CEZ group, n=37), and 3) repeated administration of FMOX every 2 hours with weight-based dosing (FMOX-B group, n=69). There were no significant differences between the three groups in terms of age, body mass index, operative time, intraoperative blood loss, specimen weight, presence of endometriosis, presence of vaginal stump hematoma, or presence of diabetes or dialysis. SSI occurred in 2.7% (n=1), 10.8% (n=4), and 0% (n=0) of patients in the FMOX-A, CEZ, and FMOX-B groups, respectively. The incidence of SSI was significantly lower in the FMOX-B group compared with the CEZ group (p=0.04), suggesting that both the type of antimicrobial prophylaxis and the method of administration may influence the prevention of SSI.