Feasiability study of prevention of incision infection without antibacterial medications for thyroidectomy

Objective To study the feasiability of prevention of incision infection without perioperative use of antibacterial medications for thyroidectomy.Methods Six hundred and sixty-seven patients underwent thyroidectomy admitted in our hospital from Feb.2005 to Aug.2011 were enrolled in this study,they were not administered with antibacterial medications for prevention of postoperative incision infection.There were 510 cases of nodular goiter,77 cases of thyroid adenoma,29 cases of Graves'disease,45 cases of thyroid papillary carcinoma and 3 cases of other malignant tumors.Unilateral total lobectomy or partial thyroidectomy was performed in 441 patients with single-side nodular goiter or thyroid adenoma; bilateral partial thyroidectomy was performed in 195 patients with nodular goiter or Graves'disease; unilateral neck lymph node resection was performed in 7 patients with thyroid papillary carcinoma and bilateral neck lymph node resection was performed in one patient with thyroid papillary carcinoma.The surgical procedure time raged from 25-390 min,the averaged time was 79.8 min.Results Re-suturing was performed in one patient due to secondary hemorrhage from residual thyroid following bilateral partial thyroidectomy for nodular goiter and 1 patient due to subtotal thyroidectomy for Graves' disease.Temporally recurrent nerve paralysis was reported as complication following right-side total lobectomy and left-side subtotal lobectomy in a nodular goiter patient.One case had suppurative infection in neck incision 5 days after bilateral partial thyroidectomy.Conclusions Classified as type-Ⅰ incision,thyroidectomy has the characteristic of small incision,short duration and minor hemorrhage.The procedure is performed under strict conditions of sterility and hemostasis,there is no need to use antibacterial medications for the prevention of incision infection and thus the use of antibiotics may be avoided.In addition to alleviate the economic burden for patients of society,especially to prevent the excessive use of antibiotics lead to bacterial resistance will have far-reaching signifance. Key words: Thyroid disease; Thyroidectomy; Antibacterial medications; Infection