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Are postoperative prophylactic antibiotics in closed reduction of nasal bone fracture valuable?: prospective study of 30 cases

  • Jang, Nam (Department of Plastic and Reconstructive Surgery, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine) ;
  • Shin, Hyun Woo (Department of Plastic and Reconstructive Surgery, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine)
  • Received : 2019.01.15
  • Accepted : 2019.03.05
  • Published : 2019.04.20

Abstract

Background: Prophylactic antibiotic administration after surgery for a nasal bone fracture is performed due to concerns about infection-related complications, such as, toxic shock syndrome. To evaluate the validity and efficacy of antibiotic use, we compared the results obtained and the bacterial profiles of nasal packing materials in patients that underwent closed reduction for a nasal bone fracture with or without prophylactic antibiotic administration. Methods: Thirty consecutive patients with a nasal bone fracture, but without an open wound, that underwent closed reduction during March to August 2017 were included in the present study. Fifteen of these 30 patients were randomly assigned to a control group, members of were administered postoperative intravenous antibiotics once at the day of surgery and then oral antibiotics for 4 days. The other 15 patients were assigned to an experimental group and not administered any antibiotic postoperatively. Antibiotic ointment was not applied to nasal packing in either group. Nasal packing was removed on postoperative day 4 in all cases. Removed nasal gauze packings were culture tested and strains identified in the two groups were compared. Results: Bacterial strain types cultured from packings were similar in the experimental and control groups and no patient showed signs of clinically significant infection. Conclusion: The findings of this study suggest postoperative prophylactic antibiotic use is not clinically required after closed reduction of a nasal bone fracture. Furthermore, the non-use of postoperative antibiotics is biologically beneficial, as it reduces the occurrence of resistant strains and medical costs, and is more convenient for patients.

Keywords

References

  1. Moon SH, Baek SO, Jung SN, Seo BF, Lee DC, Kwon H. Efficacy of biodegradable synthetic polyurethane foam for packing nasal bone fractures. J Craniofac Surg 2012;23:1848-50. https://doi.org/10.1097/SCS.0b013e31826b8247
  2. Titiz A, Zeyrek T, Ozcan M, Sabuncuoglu B, Yilmaz YF, Unal A. The effects of merocel and glove finger tampon applications on the nasal septum mucosa of rabbits. Rhinology 2008;46:112-5.
  3. Shaw CL, Dymock RB, Cowin A, Wormald PJ. Effect of packing on nasal mucosa of sheep. J Laryngol Otol 2000;114:506-9. https://doi.org/10.1258/0022215001906246
  4. Jacobson JA, Kasworm EM. Toxic shock syndrome after nasal surgery: case reports and analysis of risk factors. Arch Otolaryngol Head Neck Surg 1986;112:329-32. https://doi.org/10.1001/archotol.1986.03780030093019
  5. Brook I. Microbiology of sinusitis. Proc Am Thorac Soc 2011;8:90-100. https://doi.org/10.1513/pats.201006-038RN
  6. Choi DS, Lee JW, Yang JD, Chung HY, Cho BC, Choi KY. Minimal packing duration in close reduction for nasal bone fracture treatment. J Plast Surg Hand Surg 2015;49:275-9. https://doi.org/10.3109/2000656X.2015.1034726
  7. Todd JK, Todd BH, Franco-Buff A, Smith CM, Lawellin DW. Influence of focal growth conditions on the pathogenesis of toxic shock syndrome. J Infect Dis 1987;155:673-81. https://doi.org/10.1093/infdis/155.4.673
  8. Tierno PM Jr, Hanna BA. Magnesium and the production of toxic-shock-syndrome toxin-1 by Staphylococcus aureus. J Infect Dis 1986;153:994-6. https://doi.org/10.1093/infdis/153.5.994
  9. Jacobson JA, Stevens MH, Kasworm EM. Evaluation of singledose cefazolin prophylaxis for toxic shock syndrome. Arch Otolaryngol Head Neck Surg 1988;114:326-7. https://doi.org/10.1001/archotol.1988.01860150108025
  10. Chisholm-Burns MA, Schwinghammer TL, Wells BG, Malone PM, Kolesar JM, Dipiro JT. Pharmacotherapy principles and practice. New York: McGraw-Hill; 2010.
  11. Neugut AI, Ghatak AT, Miller RL. Anaphylaxis in the United States: an investigation into its epidemiology. Arch Intern Med 2001;161:15-21. https://doi.org/10.1001/archinte.161.1.15
  12. Bartlett JG. Detection of Clostridium difficile infection. Infect Control Hosp Epidemiol 2010;31 Suppl 1:S35-7. https://doi.org/10.1086/655999
  13. Dubberke ER, Olsen MA. Burden of Clostridium difficile on the healthcare system. Clin Infect Dis 2012;55 Suppl 2:S88-92. https://doi.org/10.1093/cid/cis335
  14. Breda SD, Jacobs JB, Lebowitz AS, Tierno PM Jr. Toxic shock syndrome in nasal surgery: a physiochemical and microbiologic evaluation of Merocel and NuGauze nasal packing. Laryngoscope 1987;97:1388-91.

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  1. Antibiotic use in nasal bone fracture: a nationwide population-based cohort study in Korea vol.22, pp.5, 2021, https://doi.org/10.7181/acfs.2021.00367