The Occurrence of Surgical Site Infection Is Not Associated with the Timing of Prophylactic Antibiotic Administration

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.

Download Full-text

Protocol for a comparison study of 1-day versus 2-day prophylactic antibiotic administration in Holmium Laser enucleation of the prostate (HoLEP): a randomized controlled trial

F1000Research ◽

10.12688/f1000research.17660.1 ◽

2019 ◽

Vol 8 ◽

pp. 161

Author(s):

Katsumi Shigemura ◽

Fukashi Yamamichi ◽

Kento Nishimoto ◽

Koichi Kitagawa ◽

Masato Fujisawa

Keyword(s):

Infectious Disease ◽

Surgical Site Infection ◽

Antimicrobial Prophylaxis ◽

Prophylactic Antibiotic ◽

University Hospital ◽

Holmium Laser ◽

Occurrence Rate ◽

Antibiotic Administration ◽

Site Infection ◽

Prostate Hyperplasia

Background: The best method of antimicrobial prophylaxis administration for surgical site infection (SSI) in transurethral holmium laser resection and enucleation of the prostate (HoLEP)/bipolar transurethral enucleation (TUEB) remains controversial. The purpose of this study is to compare one-day and two-day cefazolin in a randomized 2nd-phase study to help establish a protocol with a 95% confidence interval (CI) for SSI prevention. Methods: Patients undergoing HoLEP/TUEB for benign prostate hyperplasia without preoperative pyuria will be enrolled and randomized to receive prophylactic antibiotic administration for HoLEP/TUEB in two groups, 1-day cefazolin and 2-day cefazolin. The primary endpoint is the occurrence rate of postoperative urinary tract infection or urogenital infection within 30 days after HoLEP/TUEB with a statistical 95% CI in comparison between those groups. Secondary outcomes include the kind of infectious disease and evidence of diagnosis, day of diagnosis of infectious disease, performance of urine or blood culture, detection of bacteria, treatments, duration of treatments, AEs other than surgical site infection, and drug-induced AEs. Discussion: The results of this study will provide evidence for defining the optimal duration of cefazolin prophylactic antibiotic administration for SSI. Trial registration: This study was registered in the University Hospital Medical Information Network-Clinical Trial Registry (UMIN000027955) based on recommendations from the International Committee of Medical Journal Editors (ICMJE) on July 1st 2017.

Download Full-text

Protocol for a comparison study of 1-day (single dose) versus 2-day prophylactic antibiotic administration in Holmium Laser enucleation of the prostate (HoLEP): a randomized controlled trial

F1000Research ◽

10.12688/f1000research.17660.2 ◽

2019 ◽

Vol 8 ◽

pp. 161

Author(s):

Katsumi Shigemura ◽

Fukashi Yamamichi ◽

Kento Nishimoto ◽

Koichi Kitagawa ◽

Masato Fujisawa

Keyword(s):

Infectious Disease ◽

Single Dose ◽

Surgical Site Infection ◽

Prophylactic Antibiotic ◽

University Hospital ◽

Holmium Laser ◽

Occurrence Rate ◽

Antibiotic Administration ◽

Site Infection ◽

Prostate Hyperplasia

Background: The best method of antimicrobial prophylaxis administration for surgical site infection (SSI) in transurethral holmium laser resection and enucleation of the prostate (HoLEP)/bipolar transurethral enucleation (TUEB) remains controversial. The purpose of this study is to compare one-day and two-day cefazolin in a randomized 2nd-phase study to help establish a protocol with a 95% confidence interval (CI) for SSI prevention. Methods: Patients undergoing HoLEP/TUEB for benign prostate hyperplasia without preoperative pyuria will be enrolled and randomized to receive prophylactic antibiotic administration for HoLEP/TUEB in two groups, 1-day (single dose) cefazolin and 2-day cefazolin. The primary endpoint is the occurrence rate of postoperative urinary tract infection or urogenital infection within 30 days after HoLEP/TUEB with a statistical 95% CI in comparison between those groups. Secondary outcomes include the kind of infectious disease and evidence of diagnosis, day of diagnosis of infectious disease, performance of urine or blood culture, detection of bacteria, treatments, duration of treatments, AEs other than surgical site infection, and drug-induced AEs. Discussion: The results of this study will provide evidence for defining the optimal duration of cefazolin prophylactic antibiotic administration for SSI. Trial registration: This study was registered in the University Hospital Medical Information Network-Clinical Trial Registry (UMIN000027955) based on recommendations from the International Committee of Medical Journal Editors (ICMJE) on July 1st 2017.

Download Full-text

Does Prophylactic Antibiotic Administration Time Effect Surgical Site Infection Rates in Colorectal Surgery?

10.28971/532016da124 ◽

2016 ◽

Author(s):

Ashley Desjardins

Keyword(s):

Systematic Review ◽

Colorectal Surgery ◽

Surgical Site Infection ◽

Prophylactic Antibiotic ◽

Time Effect ◽

Antibiotic Administration ◽

Site Infection ◽

Infection Rates ◽

Design Quality ◽

Administration Time

<p>Colorectal surgery is known for having a high risk of surgical site infection (SSI). Prior research has suggested that administering prophylactic antibiotics prior to colorectal surgery may prevent SSI. This led to the question: In adult surgical patients having colorectal surgeries, does prophylactic antibiotic administration time effect surgical site infection rates within 30 days of surgery? A comprehensive literature review was completed followed by a detailed screening for inclusion and exclusion criteria, resulting in a final total of nine studies. Detailed data were collected for each study, followed by completion of critical appraisal checklists appropriate to the study design. Quality of the evidence was assessed across studies. Six of the studies were cohort studies, with only two randomized controlled trials and one systematic review. Results indicated that there is insufficient evidence to support a definite course of action for timing of antibiotic prophylaxis for colorectal surgery. The certified registered nurse anesthetist (CRNA) should be aware of the recommendations to administer antibiotics for colorectal surgery before the surgical incision based on the results of this systematic review as timing of administration can affect SSI rates. It is recommended to carefully consider antibiotic selection and timing when administering antibiotics for colorectal surgery.</p>

Download Full-text

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

Journal of Perioperative Practice ◽

10.1177/1750458919850727 ◽

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.

Download Full-text

Characterization of children submitted to cardiac surgery that developed surgical site infection

ESTIMA Brazilian Journal of Enterostomal Therapy ◽

10.30886/estima.v18.888_in ◽

2020 ◽

Author(s):

Aurilene Lima da Silva ◽

Ticiana Bezerra Castro Pontes ◽

Maria Sinara Farias ◽

Maria José Matias Muniz Filha ◽

Solange Gurgel Alexandre ◽

...

Keyword(s):

Cardiac Surgery ◽

Surgical Site Infection ◽

Prophylactic Antibiotic ◽

Site Infection ◽

Skin Preparation ◽

Descriptive Research ◽

Care Processes ◽

The City ◽

Diagnosis Of Infection

Objective: Characterize the clinical and surgical profile of children undergoing cardiac surgery who developed surgical site infection in a public hospital in the city of Fortaleza, Ceará. Methods: Descriptive research with a quantitative approach, developed in a pediatric cardiology unit, with data collected from April to June 2018. The study sample consisted of 26 children with surgical wound infection in the year 2017. Results: There were none gender prevalence; the weight range varied from 3 to 6 kg (42.3%) and neonates had a prevalence of 38%. Corrective surgeries represented 88% of the total; the surgical time varied from 2 to 6 hours (38%); 70% of the children were submitted to cardiopulmonary bypass with the predominant time of 90 to 120 minutes (27%); the diagnosis of infection was made between 4 and 6 days after the procedure. There was prophylactic antibiotic coverage in 88% and skin preparation in 92% of children. Conclusion: Characterizing the clinical-surgical profile of children undergoing cardiac surgery becomes essential for decision-making in the care processes of nurses, emphasizing the findings as a basis for the development of strategies for the prevention of surgical site infection in this clientele.

Download Full-text

COMPARATIVE STUDY OF PRE-CAESAREAN VAGINAL WASH WITH 5% POVIDONE – IODINE SOLUTION VERSUS NO WASH IN PREVENTING POSTOPERATIVE INFECTION.

10.36106/ijsr/8030301 ◽

2020 ◽

pp. 44-46

Author(s):

Sonali Deshpande ◽

Shrinivas Gadappa ◽

Dhanashree Lahane ◽

Sandeep Mannikatti

Keyword(s):

Surgical Site Infection ◽

Wound Infection ◽

Povidone Iodine ◽

Prophylactic Antibiotic ◽

Control Group ◽

Site Infection ◽

Iodine Solution ◽

Interventional Group ◽

Vaginal Wash ◽

Povidone Iodine Solution

Objective: To evaluate the efficacy of pre-cesarean vaginal wash using 5% Povidone Iodine solution on rate of post-cesarean section (CS) surgical site infection and compared with No swabbing. Method: A Prospective Randomized controlled Trial was conducted in department of Obstetrics and Gynecology in Government medical college, Aurangabad. In interventional group, vaginal swabbing with a gauze pieces impregnated with 5% Povidone Iodine solution was done for 30 seconds. The swabbing of vagina was not performed in cases assigned to control group, however the standard surgical preparation of abdomen was done in a usual manner for both group. All subject received prophylactic antibiotic cover. Collected data was complied in pre-designed proforma and analysis was done using SPSS 15. Result: The risk of post operative fever and wound infection was significantly reduced in interventional group. No measure difference was noted in seroma and composite wound infection. Also less duration of hospital stay in interventional group was noted. No adverse effect of use of Povidone iodine was reported in the interventional group. Conclusion: Vaginal swabbing with 5% Povidone-iodine pre- LSCS is inexpensive and simple intervention even for low resource setting to decrease surgical site infection.

Download Full-text

Intra-incisional versus intravenous route of antibiotic administration in preventing surgical site infections: a randomized controlled trial

International Surgery Journal ◽

10.18203/2349-2902.isj20181126 ◽

2018 ◽

Vol 5 (4) ◽

pp. 1438

Author(s):

Aditya N. Patil ◽

Veerendra M. Uppin

Keyword(s):

Single Dose ◽

Surgical Site Infection ◽

Tertiary Care ◽

Surgical Site Infections ◽

Intravenous Route ◽

Antibiotic Administration ◽

Site Infection ◽

Open Appendicectomy ◽

Group A ◽

Group B

Background: Surgical site infection (SSI) is one of the most common postoperative complications following abdominal surgeries. Whilst the use of prophylactic antibiotics has been shown to reduce postoperative wound infection, controversy still remains as to the optimum route of administration and the duration of treatment. This study aims to compare the efficacy of a preoperative single dose of a cephalosporin antibiotic (cefotaxime) administered intraincisionally versus that administered intravenously, in preventing postoperative surgical site infections following appendicectomy.Methods: Sixty consecutive cases diagnosed as uncomplicated appendicitis who consented for open appendicectomy at a tertiary care institute were included in the study. Cases were randomized to 2 comparable groups of 30 patients each. Preoperatively, patients in Group A received a single dose of Inj. Cefotaxime 1g intraincisionally while those in Group B received the same intravenously. Incision sites were examined every alternative day starting on postoperative day 3 until removal of sutures. Signs of surgical site infection, if any, were recorded and outcomes were statistically tested for significance.Results: One patient in Group A (3.3%) and 4 patients in Group B (13.3%) showed signs of postoperative surgical site infection (p >0.05) during the follow up period which prolonged their hospital stay.Conclusions: This study showed that a single dose preoperative intraincisional administration of cefotaxime was as effective as intravenous administration for prevention of postoperative surgical site infection after open appendicectomy. Although the difference was not statistically significant, there was a reduced incidence of SSI in individuals who received intraincisional antibiotic. These results are encouraging for a way forward in reducing unnecessary burdening of systemic antibiotics in patients undergoing abdominal surgeries.

Download Full-text

ANTIBIOPROPHYLAXIS AND ANTIBIOTHERAPY IN ABDOMINAL SURGERY – SHORT REVIEW

Romanian Journal of Clinical Research ◽

10.33695/rjcr.v2i1.23 ◽

2019 ◽

Vol 2 (1) ◽

pp. 37-40

Author(s):

Marina Leontescu ◽

Octavian Andronic ◽

Dan Nicolae Păduraru ◽

Alexandra Bolocan ◽

Daniel Ion

Keyword(s):

Gastrointestinal Tract ◽

Abdominal Surgery ◽

Surgical Site Infection ◽

Short Review ◽

Gastric Surgery ◽

Infectious Complications ◽

Antibiotic Administration ◽

Site Infection ◽

Intestinal Anastomoses ◽

First And Second Generation

Surgical site infection (SSI) represents a concerning for all surgeons because both the unfavorable impact on health care costs and risk factors that increase the durations of wound healing and SSI rate. A review of PubMed, Scopus and Google Scholar has been made. The keywords used were related to surgical site infection prevetion. SSIs have a raised incidence in abdominal surgery because of the fact that many types of bacterias live in the gastrointestinal tract and during a surgical procedure some may escape and cause an infection. There is a high risk of postoperatory infections in gastric surgery due to intestinal anastomoses which are predisposed to leakage. In hernia repair surgery there is a higher rate of SSIs than expected for a clean procedure, and one risk factor may be represented by the prosthetic device used. On the other hand, in laparoscopic cholecystectomy, there is a very low risk of SSI and antibioprophylaxis is not recommended. But the most contaminated procedure with the highest risk of infectious complications is colorectal surgery, which requieres a combination of antibiotics because of the numerous types of microorganism. Abdominal surgery comprises different techniques and involves most elements of the gastrointestinal tract. Some procedures need antibiotic prophylaxis and in others antibiotic administration is even prohibited. The most effective antibiotics are first and second-generation cephalosporins.

Download Full-text