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![46 World J Emerg Med, Vol 6, No 1, 2015Roodsari et al
different [median 7.5 (6,8) vs. 9 (8,10), P=0.01,
respectively]. The difference between VAS scores
comparing patients who were given prophylactic
antibiotics in the ED with those who were not given
prophylactic antibiotics was also statistically significant,
favoring no prophylactic antibiotics [median VAS: 8 (7,
and are rife with methodological flaws.[3–6]
In the present
study, we did not observe any statistical difference
between those who received prophylactic antibiotics
and those who did not. However, in the absence of a
rigorous randomized control trial, assessing the role of
prophylactic antibiotics is not possible. The low infection
Variables Infected (n=6) n (%, 95% CI) Non-infected (n=119) n (%, 95% CI) P**
Age (years)*
46 (24, 61) 28 (18, 42) 0.11
Wound length (cm)*
2.5 (1, 3) 2 (1.5, 3) 0.77
Patient satisfaction with wound appearance (VAS)*
7.5 (6, 8) 9 (8, 10) 0.01
Male gender 5 (83%, 44%–97%) 75 (63%, 54 %–71%) 0.42
Linear wound shape (vs. non-linear) 4 (67%, 30%–90%) 83 (70%, 61%–77%) 1.00
Diabetes 1 (17%, 3%–56%) 6 (5%, 2%–11%) 0.29
Receiving antibiotics in the ED 3 (50%, 19%–81%) 41 (35%, 27%–43%) 0.66
Repair method (suture vs. other methods) 5 (83%, 44%–97%) 103 (87%, 79%–92%) 0.86
Table 2. Comparison of wound characteristics in patients with and without wound infection respectively
*
: Medians and quartiles; **
: Mann-Whitney U test for comparison of age and wound length and Fisher's exact test for the rest of variables; VAS:
visual analogue scale (range 1–10); CI: confidence interval.
www.wjem.org
ection by
4 days) or
o the ED.
termined
after the
ected the
f 1–10 (1
hone.
5%–75%
ages with
and host
-infected
hitney U
t test for
Variables n/N Percent (95% CI)
Age (years)*
125 28 (18, 43)
Wound length (cm)*
125 2 (1.5, 3)
Male gender 80/125 64% (55%–72%)
Wound shape
Linear 87/125 70% (61%–77%)
Complex 38/125 30% (23%–39%)
Diabetes 7/125 6% (3%–11%)
Antibiotic prophylaxis in the ED 44/125 35% (27%–44%)
Repair method
Dressing only 11/125 9% (5%–15%)
Suture 108/125 86% (79%–91%)
Steri-strip 3/125 2% (1%–7%)
Tissue adhesive 3/125 2% (1%–7%)
Table 1. Baseline characteristics of the enrolled patients
*
: Medians and quartiles.
1%–11%, P=0.66).
Patient's satisfaction with wound appearance of the
infected and non-infected wounds were significantly](https://image.slidesharecdn.com/2017-170126235506/85/2017-1-27-7-320.jpg)
2017.1.27 単純な手の裂創における創部感染発生のリスク
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- 5. Results ・125人が本studyに参加して、その内112人は 2回目のfollow up（30日目）まで参加した。 受診時に44人（ 35%）が予防的抗菌薬投与を 受けた。125人中、創部感染は6人（4.8%）に 認めらたが、予防的抗菌薬投与を受けた群（3 人）と受けていない群（2人）では創部感染率 の有意差を認めなかった。 ・cosmeticappearanceに関しては、VASに有 意差を認め、創部非感染群のほうが創部感染 群より満足度が高かった。また予防的抗菌薬 投与においても有意差が認められ、非投与群 のほうが、投与群よりもVASが高かった。
- 6. ・また今回のstudyでは予防的抗菌薬投与を受 けた参加者（44人）と受けていない参加者 （81人）の特徴について比較解析が行われた。 予防的抗菌薬投与を受けた参加者は比較的高 齢で（median age 40yo.vs28yo.）汚染され ている創であった（6人 vs 0人） ・なお性別・創部の大きさ・形状・処置法及び 糖尿病歴の有無においては有意差を認めなか った。
- 7. 46 World JEmerg Med, Vol 6, No 1, 2015Roodsari et al different [median 7.5 (6,8) vs. 9 (8,10), P=0.01, respectively]. The difference between VAS scores comparing patients who were given prophylactic antibiotics in the ED with those who were not given prophylactic antibiotics was also statistically significant, favoring no prophylactic antibiotics [median VAS: 8 (7, and are rife with methodological flaws.[3–6] In the present study, we did not observe any statistical difference between those who received prophylactic antibiotics and those who did not. However, in the absence of a rigorous randomized control trial, assessing the role of prophylactic antibiotics is not possible. The low infection Variables Infected (n=6) n (%, 95% CI) Non-infected (n=119) n (%, 95% CI) P** Age (years)* 46 (24, 61) 28 (18, 42) 0.11 Wound length (cm)* 2.5 (1, 3) 2 (1.5, 3) 0.77 Patient satisfaction with wound appearance (VAS)* 7.5 (6, 8) 9 (8, 10) 0.01 Male gender 5 (83%, 44%–97%) 75 (63%, 54 %–71%) 0.42 Linear wound shape (vs. non-linear) 4 (67%, 30%–90%) 83 (70%, 61%–77%) 1.00 Diabetes 1 (17%, 3%–56%) 6 (5%, 2%–11%) 0.29 Receiving antibiotics in the ED 3 (50%, 19%–81%) 41 (35%, 27%–43%) 0.66 Repair method (suture vs. other methods) 5 (83%, 44%–97%) 103 (87%, 79%–92%) 0.86 Table 2. Comparison of wound characteristics in patients with and without wound infection respectively * : Medians and quartiles; ** : Mann-Whitney U test for comparison of age and wound length and Fisher's exact test for the rest of variables; VAS: visual analogue scale (range 1–10); CI: confidence interval. www.wjem.org ection by 4 days) or o the ED. termined after the ected the f 1–10 (1 hone. 5%–75% ages with and host -infected hitney U t test for Variables n/N Percent (95% CI) Age (years)* 125 28 (18, 43) Wound length (cm)* 125 2 (1.5, 3) Male gender 80/125 64% (55%–72%) Wound shape Linear 87/125 70% (61%–77%) Complex 38/125 30% (23%–39%) Diabetes 7/125 6% (3%–11%) Antibiotic prophylaxis in the ED 44/125 35% (27%–44%) Repair method Dressing only 11/125 9% (5%–15%) Suture 108/125 86% (79%–91%) Steri-strip 3/125 2% (1%–7%) Tissue adhesive 3/125 2% (1%–7%) Table 1. Baseline characteristics of the enrolled patients * : Medians and quartiles. 1%–11%, P=0.66). Patient's satisfaction with wound appearance of the infected and non-infected wounds were significantly
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- 11. Limitations ・convenience sampleであったため、医療従 事者からのenrollment biasを否定できない。 ・prospectiveobservational study（RCTでな い）であって、sample sizeは小さかったため 予防的抗菌薬投与の有効性について評価でき なかった。同じ理由で創部感染のrisk factor をも正確に同定できなかった。 ・結論として、単純な手の裂創の創部感染率は 低く、創部感染が認められた場合のcosmetic appearanceも比較的悪い。また予防的抗菌薬 投与はcase by case。
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