scholarly journals Antibiotic Prophylaxis in Elective Hand Surgery

2017 ◽  
Vol 45 (02) ◽  
pp. 089-093 ◽  
Author(s):  
Carolina Vasconcelos ◽  
Marta Serra ◽  
Rúben Nogueira ◽  
Leonor Carmo
Keyword(s):  
Retrospective Study ◽  
Surgical Site Infection ◽  
Antibiotic Prophylaxis ◽  
Infection Rate ◽  
Prophylactic Antibiotic ◽  
Hand Surgery ◽  
Diabetic Patients ◽  
Antibiotic Administration ◽  
Site Infection ◽  
Related Data

Purpose Antibiotic prophylaxis decreases the rate of surgical site infection in a broad spectrum of surgical procedures. However, in patients undergoing elective hand surgery, there is evidence of lower efficacy, and its use might be related to the development of antimicrobial resistance. The side effects and higher health-related costs must also be taken into consideration. Our aim was to assess the efficacy of antibiotic prophylaxis in these procedures. Material and methods A retrospective study was conducted including all patients who underwent clean, elective hand surgery lasting less than 30 minutes from January 1st 2014 to December 31st 2015 at our hospital. The demographic and surgery-related data were analyzed using the Statistical Package for the Social Sciences (SPSS, IBM Corp., Armonk, NY, US) software, version 23.0. Results A total of 346 patients matched the study's inclusion criteria. The infection rate was of 1%, and it was not influenced by gender, age or diabetes mellitus. Antibiotic prophylaxis was administered in 52% of the cases, and it had no effect on the decrease in the infection rate, even in the group of diabetic patients. Conclusions Despite the inherent limitations of any retrospective study, our data analysis supports the fact that prophylactic antibiotic administration does not reduce the incidence of surgical site infection in clean, elective hand surgery that lasts less than 30 minutes, even in patients at risk.

scholarly journals Standardising intraoperative irrigation with 0.05% chlorhexidine gluconate in caesarean delivery to reduce surgical site infections: A single institution experience

2019 ◽  
Vol 30 (1-2) ◽  
pp. 24-33
Author(s):  
Theresa Mangold ◽  
Erin Kinzel Hamilton ◽  
Helen Boehm Johnson ◽  
Rene Perez
Keyword(s):  
Treatment Group ◽  
Surgical Site Infection ◽  
Infection Rate ◽  
Caesarean Delivery ◽  
Chlorhexidine Gluconate ◽  
Control Group ◽  
Antibiotic Administration ◽  
Site Infection ◽  
Infection Rates ◽  
The Impact

Background Surgical site infection is a significant cause of morbidity and mortality following caesarean delivery. Objective To determine whether standardising intraoperative irrigation with 0.05% chlorhexidine gluconate during caesarean delivery could decrease infection rates. Methods This was a process improvement project involving 742 women, 343 of whom received low-pressured 0.05% chlorhexidine gluconate irrigation during caesarean delivery over a one-year period. Infection rates were compared with a standard-of-care control group (399 women) undergoing caesarean delivery the preceding year. Results The treatment group infection rate met the study goal by achieving a lower infection rate than the control group, though this was not statistically significant. A significant interaction effect between irrigation with 0.05% chlorhexidine gluconate and antibiotic administration time existed, such that infection occurrence in the treatment group was not dependent on antibiotic timing, as opposed to the control group infection occurrence, which was dependent on antibiotic timing. Conclusion Intraoperative irrigation with 0.05% chlorhexidine gluconate during caesarean delivery did not statistically significantly reduce the rate of infections. It did render the impact of antibiotic administration timing irrelevant in prevention of surgical site infection. This suggests a role for 0.05% chlorhexidine gluconate irrigation in mitigating infection risk whether antibiotic prophylaxis timing is suboptimal or ideal.

scholarly journals Effect of a single preoperative dose of oral antibiotic to reduce the incidence of surgical site infection following below-knee dermatological flap and graft repair

2019 ◽  
pp. 28-35 ◽  
Author(s):  
Helena Rosengren ◽  
Clare Heal ◽  
Petra Buettner
Keyword(s):  
Surgical Site Infection ◽  
Antibiotic Prophylaxis ◽  
Controlled Trial ◽  
Study Groups ◽  
High Dose ◽  
Antibiotic Administration ◽  
Oral Antibiotic ◽  
Site Infection ◽  
Double Blind

Background: Surgical site infection (SSI) rates for below-knee dermatological surgery are unacceptably high, particularly following complex flap and graft closures. The role of antibiotic prophylaxis for these surgical cases is uncertain. Objective: To determine whether SSI following complex dermatological closures on the leg could be reduced by antibiotic prophylaxis administered as a single oral preoperative dose. Methods: A total of 115 participants were randomized to 2 g of oral cephalexin or placebo 40-60 minutes prior to surgical incision in a prospective, randomized, double-blind, placebo-controlled trial at a primary care skin cancer clinic in North Queensland, Australia. Results: Overall 17/55 (30.9%) controls and 14/55 (25.5%) intervention participants developed infection (P = 0.525). There was no difference between the study groups in adverse symptoms that could be attributed to high-dose antibiotic administration (P = 1).

scholarly journals A Randomized Control Trial Comparing Transparent Film Dressings and Conventional Occlusive Dressings for Elective Surgical Procedures

2019 ◽  
Vol 7 (17) ◽  
pp. 2844-2850 ◽  
Author(s):  
Moushira Hosny Ezzelarab ◽  
Omar Nouh ◽  
Ahmed Nabil Ahmed ◽  
Mervat Gaber Anany ◽  
Nevine Gamal El Rachidi ◽  
...  
Keyword(s):  
Surgical Site Infection ◽  
Infection Rate ◽  
Financial Burden ◽  
P Value ◽  
Diabetic Patients ◽  
Site Infection ◽  
Surgical Site Infection Rate ◽  
Gauze Dressing ◽  
Clean Contaminated ◽  
The Impact

BACKGROUND: Surgical site infection is one of the major health-care-associated problems causing substantial morbidity and mortality and constituting a financial burden on hospitals as well. The wound management is one of the crucial evidence-based strategies in the reduction of surgical site infection rates AIM: To study the impact of standardisation of transparent semipermeable dressing procedure on the rate of surgical site infection in comparison with conventional dressing in clean and clean-contaminated surgeries. METHODS: The study included 100 patients who were admitted to surgical wards in Cairo university hospitals, for clean and clean-contaminated operations, in the period from February 2017 to August 2017. Immunocompromised and uncontrolled diabetic patients were excluded. Patients were randomly allocated into two groups; in the first group, patients wounds were covered using transparent semipermeable dressing, while the second group patients’ wounds were covered using conventional occlusive gauze dressing. Patients were followed up for criteria of infection every other day during the first week then at two weeks, three weeks and four weeks. RESULTS: In clean and clean-contaminated operations, the transparent dressing group showed a significantly lesser rate of surgical site infection at (2%), compared with the conventional occlusive gauze dressing group with a surgical site infection rate of (14%) (p-value of 0.02). CONCLUSION: The transparent semipermeable dressing is effective in reducing surgical site infection rate in clean and clean-contaminated operations.

scholarly journals A Prospective Evaluation of Adverse Reactions to Single-Dose Intravenous Antibiotic Prophylaxis During Outpatient Hand Surgery

Hand ◽  
2018 ◽  
Vol 15 (1) ◽  
pp. 41-44 ◽  
Author(s):  
Kristin Sandrowski ◽  
David Edelman ◽  
Michael Rivlin ◽  
Christopher Jones ◽  
Mark Wang ◽  
...  
Keyword(s):  
Adverse Reaction ◽  
Single Dose ◽  
Antibiotic Prophylaxis ◽  
Upper Extremity ◽  
Adverse Reactions ◽  
Prophylactic Antibiotic ◽  
Hand Surgery ◽  
Outpatient Setting ◽  
Study Cohort ◽  
Antibiotic Administration

Background: While it is established that routine prophylactic antibiotics are not needed for all hand surgery, some cases do require it. The purpose of this study was to determine the rate of adverse reactions resulting from prophylactic antibiotic administration on patients undergoing outpatient hand and upper extremity surgical procedures. We hypothesize that the rate of complications resulting from the use of antibiotic prophylaxis is smaller than that reported in the currently referenced literature. Methods: We prospectively evaluated 570 consecutive patients undergoing outpatient upper extremity surgery. Patients were excluded if they were on antibiotics prior to surgery, were discharged on antibiotics, or if they wished to be excluded. Nineteen patients were excluded, resulting in a study cohort of 551 patients. Patients were monitored perioperatively, 2 to 3 days postoperatively, during the first postoperative visit and 1 month postoperatively for adverse reactions. The type and timing of the adverse reaction was recorded. Results: Five hundred fifty-one patients were included for evaluation and 8 patients (1.5%) developed an adverse reaction to antibiotics. Five patients (0.9%) reported a rash and 3 patients (0.5%) reported diarrhea within 3 days of surgery. There were no anaphylactic reactions or complications necessitating hospital transfer or admission in the postoperative period. Conclusion: This study represents a prospective investigation designed to determine the rate of adverse reactions to single-dose antibiotics given during outpatient hand surgery. We conclude that the use of intravenous, single-dose prophylactic antibiotic is safe in the outpatient setting for cases that require it.

scholarly journals ANTIBIOTIC PROPHYLAXIS IN BARIATRIC SURGERY: a continuous infusion of cefazolin versus ampicillin/sulbactam and ertapenem

2015 ◽  
Vol 52 (2) ◽  
pp. 83-87 ◽  
Author(s):  
Álvaro Antônio Bandeira FERRAZ ◽  
Luciana Teixeira de SIQUEIRA ◽  
Josemberg Marins CAMPOS ◽  
Guido Correa de ARAÚJO JUNIOR ◽  
Euclides Dias MARTINS FILHO ◽  
...  
Keyword(s):  
Surgical Site Infection ◽  
Antibiotic Prophylaxis ◽  
Continuous Infusion ◽  
Prophylactic Antibiotic ◽  
Surgical Site Infections ◽  
Anesthesia Induction ◽  
Site Infection ◽  
Cross Sectional ◽  
Group I ◽  
Bariatric Patients

Background The incidence of surgical site infection in bariatric patients is significant and the current recommendations for antibiotic prophylaxis are sometimes inadequate. Objective The aim of this study was to analyze the effect of three prophylactic antibiotic regimens on the incidence of surgical site infection. Methods A prospective, cross-sectional study was conducted between January 2009 and January 2013 in which 896 Roux-en-Y gastric bypasses were performed to treat obesity. The study compared three groups of patients according to the perioperative antibiotic prophylaxis administered intravenously and beginning at anesthesia induction: Group I consisting of 194 patients treated with two 3-g doses of ampicillin/sulbactam; Group II with 303 patients treated with a single 1-g dose of ertapenem; and Group III with 399 patients treated with a 2-g dose of cefazolin at anesthesia induction followed by a continuous infusion of cefazolin 1g throughout the surgical procedure. The rate of surgical site infection was analyzed, as well as its association with age, sex, preoperative weight, body mass index and comorbidities. Results The rates of surgical site infection were 4.16% in the group treated prophylactically with ampicillin/sulbactam, 1.98% in the ertapenem group and 1.55% in the continuous cefazolin group. Conclusion The prophylactic use of continuous cefazolin in surgeries for morbid obesity shows very promising results. These findings suggest that some prophylactic regimens need to be reconsidered and even substituted by more effective therapies for the prevention of surgical site infections in bariatric patients.

scholarly journals Antibiotic Prophylaxis In Preventing Surgical Site Infection In Patients Undergoing Lichtenstein’s Hernioplasty

2018 ◽  
Vol 08 (03) ◽  
pp. 147-150
Author(s):  
Rizwanullah Junaid Bhanbhro ◽  
Khalil Ahmed Almani ◽  
Sadia Kazi
Keyword(s):  
Inguinal Hernia ◽  
Surgical Site Infection ◽  
Antibiotic Prophylaxis ◽  
Prophylactic Antibiotic ◽  
University Hospital ◽  
Site Infection ◽  
Inguinal Hernioplasty ◽  
Exclusion Criteria ◽  
Antibiotic Group ◽  
Low Incidence

Objective: To determine the antibiotic prophylaxis in preventing surgical site infection in patients undergoing Lichtenstein’s hernioplasty. Study design: Observational study Place and Duration: Department of surgery, ISRA University Hospital, Hyderabad. from December 2015 to March 2017. Materials and Methods: 120 cases of inguinal hernia planned for Lichtenstein’s hernioplasty were selected according to exclusion criteria and divided into control and antibiotic group. Pre- operative patient history, physical examination and inguinal hernia examination was performed. Prophylactic antibiotic ceftriaxone (1000 mg) was given over night of surgical procedure. Statistical software SPSS 21.0 was used for data analysis at 95% CI (P <0.05). Results: Mean± SD age was noted as 39.51 ± 7.56 years (15 – 61 years). Of 120, who underwent Lichtenstein’s hernioplasty the direct and indirect hernias were noted in 35 (29.16%) and 33 (27.5%) & 25 (20.83%) and 27 (22.5%) of control and antibiotic groups respectively. Of 120 subjects, the SSI was noted in 17 (14.1%) in control and 5 (4.16%) in antibiotic group. Cumulative SSI in 120 cases was 22 (18.33%). Conclusion: The present study reports low incidence of surgical site infection with antibiotic prophylaxis in Lichtenstein’s mesh repair in open inguinal hernioplasty.

scholarly journals Analysing the Effect of Prophylaxis Antibiotic Administration on Pediatric Clean Surgery Based on Post Operative Response of Neutrophil, Monocyte, and Lymphocyte, and Surgical Site Infection Rate

2018 ◽  
Vol 5 (1) ◽  
pp. 3430-3434
Author(s):  
Andrizal Yoesoef ◽  
Erjan Fikri ◽  
Aznan Lelo
Keyword(s):  
Surgical Site Infection ◽  
Infection Rate ◽  
Tissue Injury ◽  
Wound Complication ◽  
Developed Countries ◽  
Antibiotic Administration ◽  
Site Infection ◽  
Surgical Wound ◽  
Surgical Site Infection Rate ◽  
Double Blind

Insignificant administration of antibiotic leads to higher health cost and increase of antibiotic resistance. National prophylaxis antibiotic guideline on clean surgery amongst developed countries are varies meanwhile most developing countries still do not have any and adopt the established guidelines, not to mention there is not many specific guidelines for pediatric procedure. In Indonesia, 30% to 80% antibiotic usage was proven unnecessary. This study analysed the effect prophylaxis antibiotic administration on pediatric clean surgery based on post operative response of neutrophil, monocyte, and lymphocyte, as the parameters of cell-mediated inflammatory response on tissue injury or infection, and surgical site infection rate. A double blind randomized clinical trial was conducted from May 2013 to April 2014 at multi-hospital in Medan, Indonesia. Total sample is 42 subjects, distributed evenly into 2 groups. Post operative blood sample was examined on 3rd day and surgical wound was evaluated until 30th day. Both groups were comparable in patients’ demographic, clinical characteristic, and surgery procedure. Post operative rates of neutrophil, monocyte, and lymphocyte are not statistically different between groups (P = 0.083, P = 0.121, dan P = 0.486). Pre and post operative difference rates of neutrophil, monocyte, and lymphocyte are not statistically different between groups (P = 0.065, P = 0.294, dan P = 0.367). Surgical wound complication was 2.4% of total 42 sample (P = 1,00) with 0% surgical site infection event on both groups. This study recommends prophylaxis antibiotic administration on pediatric clean surgery is not necessary.

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