DOI: http://dx.doi.org/10.18203/2349-2902.isj20160215

A comparative prospective study of preoperative antibiotic prophylaxis in the prevention of surgical site infections

Suresh Karlatti, I. B. Havannavar

Abstract


Background: Most common cause of post-operative morbidity is surgical site infection (SSI) in planned cases accounting nearly 65% to 80% of all cases in our population. Prior to the use of prophylactic antibiotic, the incidence of surgical site infection was more, which has been drastically reduced the incidence of surgical site infection. This study was conducted to know the need for antibiotic prophylaxis in clean, clean-contaminated surgical wounds and whether prophylactic antibiotic is itself sufficient to minimize surgical site infection.

Methods: 300 patients admitted during January 2011 to December 2012 in District hospital Belgaum, attached to Belgaum Institute of Medical Sciences were selected for our study and were subjected for clean or clean contaminated surgeries done under meticulous surgical technique.

Results: Our study showed that there is no need for prophylactic antibiotics in cases of clean surgeries. We recommend antibiotic prophylaxis in clean contaminated cases. The incidence of surgical site infection depends on various factors like old age (21.91%), anaemia (23.97%), Diabetes mellitus (20.54%) and prolonged duration of surgery more than 2 hours (14.38%).  

Conclusions: From this study we can conclude that, in cases of clean surgeries there is no need for prophylactic antibiotics, as there is no statistical significance, whereas in clean contaminated cases antibiotic prophylaxis is recommended as it reduces SSI statistically significant.


Keywords


Clean, Clean contaminated, Prophylactic antibiotic, Risk factors, Surgical site infection

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References


Anderson DJ, Sexton DJ. Epidemiology and pathogenesis of and risk factors for surgical site infection. Up-to-date. 2008. http://www. uptodate.com.

Mangram AJ, Horan TC, Pearson ML, Silver LC, Jarvis WR. Guideline for prevention of surgical site infection: 1999. Hospital Infection Control Practices Advisory Committee. Infect Control Hosp Epidemiol. 1999;20(4):250-78.

Lewis RT, Klein H. Risk factors and post-operative sepsis: Significance of preoperative lymphocytopenia. J Surg Res. 1975;26:365-71.

Strachan CJ, Black JP. Prophylactic use of Cefazolin against sepsis after cholecystectomy. British Journal of Medicine. 1977;l:1254-7.

Page CP, Bohnen JM, Fletcher JR. Antimicrobial prophylaxis for surgical wounds: Guidelines for clinical care. Arch Surg. 1993;128:79-88.

Rao AS, Harsha M. Post-operative wound infection. J India Med Assoc. 1975;44:90-3.

Hamilton HW, Hamilton KR, Lone FJ. Preoperative hair removal. The Canadian Journal of Surgery. 1997;20:269-75.

Cruise PJE, Foord R. A five year prospective study of 23,649 surgical wounds' Archives of surgery. 1913;107:206.

Funary AP, Zerc KJ, Grunkemeier GC, Starr A. Continuous intravenous insulin infusion reduces the incidence of deep sterna wound infection in diabetic patients after cardiac surgical procedures. Ann Thorac Surg. 1999;67:352-60.

Lilani, Jangale N. Department of microbiology, Department of surgery, Grant medical college, Byculla , Mumbai. Indian J Surg. 1997;90-3.

Carlson GE, Gonnlanakis C, Tsatsakis A. Pre-incisional single dose ceftriaxone for prophylaxis of surgical wound. American Journal of Surgery. 1995;170(4):353-5.