Collatamp를 이용한 소아수술에서의 효용성
Efficacy of Collatamp on Pediatric Urologic Surgery
0
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
Purpose: The purpose of this study is to evaluate efficacy of Collatamp (EUSA Pharma [Europe]; a gentamicin-containing collagen implant, GCCI) in pediatric urologic surgery. Materials and Methods: The study comprised a retrospective analysis of 35 consecutive children who underwent pediatric urologic surgery for treatment of hydrocele, undescended testis and varicocele between March 2013 and March 2015. Collatamp containing 130 mg gentamicin and 280 mg collagen were immersed in 300 ml normal saline for up to 6 hours. At set times after immersion the GCCI were removed, the saline diluted in normal human serum and the gentamicin content assayed by a validated immunoassay (Cedia, Microgenics Ltd., UK) to provide an estimate of the loss from each implant. Patients were classified according to two groups: patients with Collatamp (group A) and those without Collatamp (group B). Postoperative complication, operative time and age, etc. were assessed at postoperative 7 days.Results: Sixteen hydrocele, 16 undescended testis, and 3 varicocele patients were identified, with a median age of 87.43±54.10 months, operation time of 103.60±29.41 minutes, and hospitalization period of 3.20±0.68 days. Mean age, operation time, and hospitalization period in group A, B was 64.81±60.32 months, 100.80±46.80 months (p=0.02), 122.30±40.70 minutes, 103.61±29.39 minutes (p=0.17), and 3.20±0.40 days, 3.20±0.80 days (p=0.67), respectively. No statistically significant differences in postoperative complication were observed between the two groups. However, cost was higher in group A than in group B (300,000 won vs, 15,900.82±3,905.72 won).Conclusions: Collatamp may be useful and effective in preventing wound infection in pediatric urologic surgery, although Collatamp is more expensive.
Abstract
Purpose: The purpose of this study is to evaluate efficacy of Collatamp (EUSA Pharma [Europe]; a gentamicin-containing collagen implant, GCCI) in pediatric urologic surgery. Materials and Methods: The study comprised a retrospective analysis of 35 consecutive children who underwent pediatric urologic surgery for treatment of hydrocele, undescended testis and varicocele between March 2013 and March 2015. Collatamp containing 130 mg gentamicin and 280 mg collagen were immersed in 300 ml normal saline for up to 6 hours. At set times after immersion the GCCI were removed, the saline diluted in normal human serum and the gentamicin content assayed by a validated immunoassay (Cedia, Microgenics Ltd., UK) to provide an estimate of the loss from each implant. Patients were classified according to two groups: patients with Collatamp (group A) and those without Collatamp (group B). Postoperative complication, operative time and age, etc. were assessed at postoperative 7 days.Results: Sixteen hydrocele, 16 undescended testis, and 3 varicocele patients were identified, with a median age of 87.43±54.10 months, operation time of 103.60±29.41 minutes, and hospitalization period of 3.20±0.68 days. Mean age, operation time, and hospitalization period in group A, B was 64.81±60.32 months, 100.80±46.80 months (p=0.02), 122.30±40.70 minutes, 103.61±29.39 minutes (p=0.17), and 3.20±0.40 days, 3.20±0.80 days (p=0.67), respectively. No statistically significant differences in postoperative complication were observed between the two groups. However, cost was higher in group A than in group B (300,000 won vs, 15,900.82±3,905.72 won).Conclusions: Collatamp may be useful and effective in preventing wound infection in pediatric urologic surgery, although Collatamp is more expensive.
참고문헌 (17)
- Kanamaru S, "Assessment of a protocol for prophylactic antibiotics to prevent perioperative infection in urological surgery: a preliminary study", Int J Urol, 11, pp.355~363 (2004)
- Chang WK, "Gentamicin-collagen implants to reduce surgical site infection: systematic review and meta-analysis of randomized trials", Ann Surg, 258, pp.59~65 (2013)
- Picó RB, "Prospective study comparing the incidence of wound infection following appendectomy for acute appendicitis in children: conventional treatment versus using reabsorbable antibacterial suture or gentamicin-impregnated collagen fleeces", Cir Pediatr, 21, pp.199~202 (2008)
- Mangram AJ, "Guideline for prevention of surgical site infection, 1999. Centers for Disease Control and Prevention (CDC) Hospital Infection Control Practices Advisory Committee", Am J Infect Control, 27, pp.97~132 (1999)
- Laxenaire MC, "Epidemiology of anesthetic anaphylactoid reactions. Fourth multicenter survey (July 1994-December 1996)", Ann Fr Anesth Reanim, 18, pp.796~809 (1999)
- Lee CW, "Perioperative anaphylaxis to cefazolin", Allergy Asthma Proc, 25, pp.23~26 (2004)
- Espin-Basany E, "Prospective, randomised study on antibiotic prophylaxis in colorectal surgery. Is it really necessary to use oral antibiotics", Int J Colorectal Dis, 20, pp.542~546 (2005)
- Rangel SJ, "Recent trends in the use of antibiotic prophylaxis in pediatric surgery", J Pediatr Surg, 46, pp.366~371 (2011)
- Bratzler DW, "Antimicrobial prophylaxis for surgery: an advisory statement from the National Surgical Infection Prevention Project", Am J Surg, 189, pp.395~404 (2005)
- Haas H, "Antibiotic prophylaxis in visceral and urologic pædiatric surgery", Arch Pediatr, 20(Suppl 3), pp.S67~S73 (2013)
- Meijer WS, "Meta-analysis of randomized, controlled clinical trials of antibiotic prophylaxis in biliary tract surgery", Br J Surg, 77, pp.283~290 (1990)
- Page CP, "Antimicrobial prophylaxis for surgical wounds. Guidelines for clinical care", Arch Surg, 128, pp.79~88 (1993)
- Vuorisalo S, "Is single-dose antibiotic prophylaxis sufficient for coronary artery bypass surgery? An analysis of peri- and postoperative serum cefuroxime and vancomycin levels", J Hosp Infect, 37, pp.237~247 (1997)
- Hsieh MH, "Surgical antibiotic practices among pediatric urologists in the United States", J Pediatr Urol, 7, pp.192~197 (2011)
- Chung JM, "The use of prophylactic antibiotics in pediatric urologic surgery: a questionnaire survey of pediatric urologist in Korea", J Korean Pediatr Urol, 2, pp.29~37 (2010)
- Bennett-Guerrero E, "Gentamicin-collagen sponge for infection prophylaxis in colorectal surgery", N Engl J Med, 363, pp.1038~1049 (2010)
- 남형종, "소아비뇨기과 통원수술 환자에서 예방적 항생제 사용의 임상지침 확립을 위한 연구", Korean J Urogenit Tract Infect Inflamm, 7(1), pp.50~55 (2012), 대한요로생식기감염학회[DOI]