| Objective:The use of antibiotics in septoplasty is commonly used by most orthopedic and otolaryngological doctors,but there is currently no available evidence to formulate that the routine use of antibiotics has a definite help and preventive effect on the postoperative recovery of nasal plastic surgery and on the incidence of related complications.There is still a lot dispute at home and abroad about whether to use antibiotics,Some surgeons think it is necessary,while others hold the opposite opinion.Therefore,in order to clarify the necessity and effectiveness of using antibiotics after nasal septoplasty,we systematically evaluated and analyzed the effectiveness of antibiotics by systematic reviews and meta-analyzes of previous randomized controlled clinical trials of antibiotics applied to nasal septoplasty published at home and abroad.Using evidence-based methods to find scientific evidence to guide clinical trials.Materials and Methods:Retrieving related RCT on the use of antibiotics before and after Septoplasty,collecting all published studies,Chinese and English database and search engines: Pub Med,Pub Med,SCI,Embase,The Cochrane Library,Google Scholar,etc.The data of retrial is from January 1980 to January31,2018.After the literature was retrieved,inclusion criteria were excluded and assessed using the Cochrane Risk Bias Evaluation Tool.Outcomes: After the Septoplsty,it was divided into observation group,experimental group and control group based on the timing and duration of antibiotic intervention.7 days after the surgery we evaluated each index uniformly.The post operative infection rate of different groups were merged for analysis by Rev Man 5.3.The results were tested for heterogeneity,and the significance of intervention was evaluated.Results:In this Meta-Analysis,four articles were included,both in English,and the Cochrane Risk of Risk Software showed a lower risk bias.(Less than 10 included in the literature,unpublished bias evaluation).(1)There were 5 RCTs in experimental group and control group,470 were included in the experimental group,101 were postoperatively infected,451 were included in the control group,and 87 were postoperative infections.Fixed effect model analysis: RR(95% CL)was 1.13 [0.93,1.37],I2=16%(p=0.22).(2)3 RCTs were observed in the observation group and the experimental group.364 cases were included in the observation group,45 cases were postoperative infections,300 cases were included in the experimental group,and 28 cases were postoperative infections.Fixed effect model analysis: RR(95% CL)was 1.28 [0.82,1.99],I2=45%(p=0.27).(3)268 cases of non-antibiotic group,37 cases of infection,189 cases of antibiotics group and 20 cases of infection in non-antibiotic group and continuous antibiotics group after operation.RR(95% CL)was 1.30 [0.78,2.17],I2 = 0%(p = 0.81)Conclusions:(1)Although the timing and duration of antibiotics were different,the incidence of postoperative infection rate after Septoplasty in experimental group and control group didn’t have statistical significance,Z=1.24,(P=0.22).the evidence is not sufficient to explain that the timing and duration of the usage of antibiotics play a decisive role to the incidence of infection.(2)There was also no statistical difference in the incidence of post operative infection between the observation group and the experimental group,Z=1.10,(p=0.27).(3)Compared with the observation group and the control group,Z=1.02,(P=0.31).It still has no statistical difference.In summary,According to the large sample of RTCs,no evidence can currently prove that the incidence of post operative infection of Septoplasty is statistically different,no matter when and how long it was intervened,or even not intervened.Therefore,the intervention of antibiotics does not prevent or reduce the infection.We can correct the nonstandard application of antibiotics and avoid unnecessary postoperative infection by knowing the indications,enforcing preoperative standard strictly,and improving the nursing after the surgery. |
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