OBJECTIVE To investigate and analyze the application of prophylactic antibiotics in perioperative period in hospital.METHODS Totally 2 055 cases under operation were investigated prospectively from Jun to Dec in 2005.RESULTS The rate of antibiotics usage was 99.95% among the 2 055 cases.The usage of antibiotics in aseptic wound was 99.92%,and in aseptic-contaminative and contaminative wound was all 100%;72.47% of the patients received single antibiotic treatment,25.84% and 1.12% received 2 to 3 kinds of antibiotics combined therapy respectively.The mean time of the usage of antibiotics during perioperative period was 8.16 days,and that for aseptic,aseptic-contaminative and contaminative wound was 8.1,8.2,and 8.2 days,respectively.29.65% Patients were given antibiotics in 0.5-2 hours before operation,68% were given after operation.The duration of antibiotics therapy less than 48 hours was only 3.45%.The rate of wound infection was 0.75% in patients. The rate of wound infection of aseptic,aseptic-contaminative and contaminative operations was 0.29%,1.33% and 3.42%,respectively.CONCLUSIONS Application of prophylactic antibiotics during perioperative period in hospital is not reasonable.The problem is improper time that given antibiotics,improper kind of antibiotics selected and too long duration of the antibiotics therapy.It is necessary that the antibiotics administration should be standardized.

Objective To evaluate the effects of multimodal analgesia on postoperative rehabilitation in patients with lower limbs free flap transplantation. Methods A total of 100 patients scheduled for lower limbs free flap transplantation of department of traumatology and orthopedics were recruited from December 2013 to March 2015 in Nanfang Hospital of Southern Medical University. They were randomly divided into experimental group ( 50 cases, multimodal analgesia including patient-controlled analgesia, oral or vein painkillers on schedule and ration, on demand) and control group ( 50 cases, analgesia on demand, giving routine analgesia medicine according to the actual demands of patients). The effects of analgesia and sedation, sleep quality, satisfaction degree of patients towards discharge, the situation of angiospasm, the blood flow of skin flaps blood-vessels were compared between two groups. Results Repeat measurement of variance analysis results showed that there were significant differences among scores of the visual analogue scale ( VAS) on postoperative patients with multimodal analgesia in different time points (8, 16, 24, 32, 40, 48h after operation) (Ftime=9.89, P<0. 01) . The differences of VAS scores between experimental group and control group was statistically significant (Fbetweengroup=4.84, P<0.05). Time effect and intervention interacted with each other (Finteraction=2.27, P<0. 05) . There were no significant differences among scores of Ramesay on postoperative patients with multimodal analgesia in different time points (8, 16, 24, 32, 40, 48h after operation) (Ftime=1.29, P>0.05). Statistical significance was found in Ramesay scores between experimental group and control group was ( Fbetween group=6.84, P<0.05) . Time effect and intervention interacted with each other ( Finteraction=5.41, P<0.05) . The score of sleep quality (3.7±1.1) in experimental group were lower than that in control group (5.2±1.9). The blood flow velocity of skin flaps blood-vessels in experimental group [(7.21±1.84) mm/s] was higher than that in control group [(6.21±1.43) mm/s] (t=2.254, P<0.05). The tension of skin flap in experimental group [(7.63± 1. 23) N] was lower than that in control group [(8.24±2.01) N]. Differences were statistically significant (t=2. 771, 2. 254, 2.006;P<0.05). Conclusions The multimodal analgesia can improve the effects of analgesia and sedation, sleep quality and microcirculation of local skin slaps in patients with lower limbs free flap transplantation.