• Cir Cir · Jan 2009

    Randomized Controlled Trial Comparative Study

    [Are antimicrobials useful in closed thoracostomy due to trauma?].

    • Felipe Villegas-Carlos, Aarón Moisés Vázquez-Martínez, Javier Alfonso Pinedo-Onofre, Lorenzo Guevara-Torres, Jaime Arístides Belmares-Taboada, and Martín Sánchez-Aguilar.
    • Hospital Central "Dr. Ignacio Morones Prieto", San Luis Potosí, San Luis Potosí, México. medifelipe@hotmail.com
    • Cir Cir. 2009 Jan 1; 77 (1): 29-32.

    BackgroundThoracic trauma accounts for 25% of deaths due to trauma. Chest trauma patients generally present to the emergency room with pneumo- or hemothorax. According to the majority of the studies, management of closed thoracostomy for trauma includes the use of antimicrobial drugs to prevent infectious complications, but this has not been proven to be beneficial. We undertook this study to evaluate antimicrobial use in thoracic trauma patients with closed thoracostomy and its impact on the development of infectious complications.MethodsWe carried out a prospective, randomized, double blind, comparative study. Patients with isolated chest trauma requiring closed thoracostomy were divided into two groups. Group A received cefalotin, and group B received placebo. Ages ranged from 15-65 years. Results were analyzed with chi(2) and Fisher exact test.ResultsOne hundred twenty six patients were included in this study. There were 63 patients in each group with similar demographic characteristics. The mean length of hospital stay with the tube was 6.56 days, but the average stay was 11 days for patients who developed empyema. Eight patients developed empyema, three patients with empyema belonged to group A patients and five patients with empyema belonged to group B. For empyema management, five cases were resolved by chest drainage, two cases required thoracoscopic cleaning and drainage and one patient was resolved with thoracotomy and pleural decortication. Bivariate analysis comparing antimicrobial use vs. empyema and length of drainage vs. antimicrobials did not show a statistically significant difference.ConclusionsThe present study did not demonstrate that antimicrobial use was beneficial in the prevention of pleural infections in the management of chest trauma patients requiring closed thoracostomy.

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