Prevention of surgical site infection in lower limb skin lesion excisions with single dose oral antibiotic prophylaxis: a prospective randomised placebo-controlled double-blind trial

Objectives: To determine the effectiveness of a single perioperative prophylactic 2 g dose of cephalexin in preventing surgical site infection (SSI) following excision of skin lesions from the lower limb. Design: Prospective double-blinded placebo-controlled trial testing for difference in infection rates. Setting: Primary care in regional North Queensland, Australia. Participants: 52 patients undergoing lower limb skin lesion excision. Interventions: 2 g dose of cephalexin 30–60 min before excision. Main outcome measures: Incidence of SSI. Results: Incidence of SSI was 12.5% (95% CI 2.7% to 32.4%) in the cephalexin group compared with 35.7% (95% CI 18.6% to 55.9%) in the placebo group (p=0.064). This represented an absolute reduction of 23.21% (95% CI −0.39% to 46.82%), relative reduction of 65.00% (95% CI −12.70% to 89.13%) and number-needed-to-treat of 4.3. Conclusions: Administration of a single 2 g dose of cephalexin 30–60 min before skin lesion excision from the lower limb may pro...

研究目的：明确单次围手术期预防性给予2g头孢氨苄（cephalexin）对下肢皮肤病灶切除术后手术部位感染（Surgical Site Infection, SSI）的预防效果。
研究设计：采用前瞻性双盲安慰剂对照试验，检验两组感染率的差异。
研究地点：澳大利亚昆士兰州北部基层医疗机构。
研究对象：52例行下肢皮肤病灶切除术的患者。
干预措施：于病灶切除前30~60分钟给予单次2g剂量的头孢氨苄。
主要结局指标：手术部位感染发生率。
研究结果：头孢氨苄组手术部位感染发生率为12.5%（95%置信区间2.7%~32.4%），安慰剂组为35.7%（95%置信区间18.6%~55.9%），组间差异无统计学意义（P=0.064）。两组绝对风险降低值为23.21%（95%置信区间-0.39%~46.82%），相对风险降低值为65.00%（95%置信区间-12.70%~89.13%），需治疗人数为4.3。
研究结论：于下肢皮肤病灶切除前30~60分钟单次给予2g剂量的头孢氨苄，或可