Antibiotic prophylaxis of postoperative neurosurgical wound infection

1982 ◽  
Vol 56 (1) ◽  
pp. 103-105 ◽  
Author(s):  
Stephen J. Haines ◽  
Michael L. Goodman
Keyword(s):  
Clinical Trials ◽  
Antibiotic Prophylaxis ◽  
Wound Infection ◽  
Infection Rate ◽  
Neurosurgical Procedures ◽  
Postoperative Wound Infection ◽  
Controlled Clinical Trials ◽  
Content Type ◽  
Postoperative Wound ◽  
Fine Print

✓ In an effort to reduce the incidence of postoperative wound infection, the recently proposed regimen of intravenous vancomycin and tobramycin and streptomycin irrigating solution was used in 878 neurosurgical operations. There were eight infections, for an infection rate of 0.9%. This infection rate was compared to the rate in the previously reported series using a sequential statistical analysis. The infection rate was found to be signficantly greater than that previously reported. Controlled clinical trials will be required before the efficacy of antibiotic prophylaxis in clean neurosurgical procedures can be considered proven.

Wide variation in risk of wound infection following clean neurosurgery

1985 ◽  
Vol 62 (2) ◽  
pp. 243-247 ◽  
Author(s):  
James H. Tenney ◽  
David Vlahov ◽  
Michael Salcman ◽  
Thomas B. Ducker
Keyword(s):  
Wound Infection ◽  
Wound Infection Rate ◽  
Neurosurgical Procedures ◽  
Postoperative Wound Infection ◽  
Content Type ◽  
Postoperative Wound ◽  
Deep Wound Infection ◽  
Deep Wound ◽  
Potential Efficacy ◽  
Perioperative Antibiotics

✓ The authors have prospectively examined the occurrence of postoperative wound infection following clean neurosurgery in 936 patients. Fewer than 1% received perioperative antibiotic prophylaxis. The overall rate of deep wound infection was 2.6%; no deaths were directly attributable to these infections. Deep wound infections occurred significantly more frequently following craniotomy (4.3%) than following spinal (0.9%) or other clean neurosurgery. Among craniotomies, the deep wound infection rate varied significantly from 11% following repeat operations for recurrent gliomas to 2.5% following non-tumor surgery. Risk of deep wound infection varied more than 11-fold depending on the type of clean neurosurgical operation. It is most feasible to demonstrate the potential efficacy of perioperative antibiotics in clean neurosurgical procedures with the greatest risk of postoperative wound infection. The potential benefit from such prophylaxis would be greatest for patients undergoing these high-risk operations.

Prophylactic parenteral antibiotics in clean neurosurgical procedures: a review

1988 ◽  
Vol 69 (1) ◽  
pp. 52-57 ◽  
Author(s):  
Robert Dempsey ◽  
Robert P. Rapp ◽  
Byron Young ◽  
Sarah Johnston ◽  
Phillip Tibbs
Keyword(s):  
Wound Infection ◽  
First Generation ◽  
Prophylactic Antibiotic ◽  
Neurosurgical Procedures ◽  
Postoperative Wound Infection ◽  
Gram Positive ◽  
Content Type ◽  
Postoperative Wound ◽  
The Cost ◽  
Antibiotic Agents

✓ Clean surgical procedures carry a risk of postoperative wound infection that is less than 5% in most hospitals. The use of prophylactic antibiotic agents in clean neurosurgical cases is controversial, and the neurosurgical literature through 1980 contains no controlled clinical trials to study its effectiveness in such cases. A report of 1732 consecutive procedures without a single postoperative wound infection in patients receiving systemic gentamicin, vancomycin, and streptomycin irrigation fluids is often quoted by neurosurgeons; however, these results have not yet been duplicated by others. Since 1980, there have been several controlled trials that support the use in clean neurosurgical cases of prophylactic antibiotics, including the vancomycin/gentamicin/streptomycin regimen and the first-generation cephalosporins. A report in 1986 of 1602 cases without a primary wound infection supports the use of a single perioperative dose of cefazolin. A review of causative organisms in postoperative wound infections demonstrates the preponderance of Gram-positive pathogens. Therefore, when antibiotic prophylaxis is indicated, adequate Gram-positive bacterial coverage, including protection against Staphylococcus infection, is required. With consideration of the present data, the cost of antibiotic therapy, and the danger of drug toxicity, a short perioperative regimen of cefazolin as prophylaxis is preferred in clean neurosurgical cases.

scholarly journals POST OPERATIVE WOUND INFECTION

2010 ◽  
Vol 17 (02) ◽  
pp. 174-179
Author(s):  
AAMIR IJAZ ◽  
SUHAIL AMER
Keyword(s):  
Inguinal Hernia ◽  
Hernia Repair ◽  
Antibiotic Prophylaxis ◽  
Wound Infection ◽  
Prophylactic Antibiotics ◽  
Postoperative Wound Infection ◽  
Wound Infections ◽  
Postoperative Wound ◽  
Lichtenstein Hernia Repair ◽  
Significant Difference

Background: The use of antibiotic prophylaxis during Lichtenstein inguinal hernia surgery is controversial, and no definitive guidelines are available in literature. Objective: To determine effects of prophylactic antibiotics in reducing the frequency of postoperative wound infection in Lichtenstein hernia repair. Study Design: Case control study. Setting: Surgical Unit II, Allied Hospital, Faisalabad. Duration: One year, between January 2007 and December 2007. Methods: Patients undergoing unilateral, primary inguinal hernia repairelectively with the Lichtenstein technique using polypropylene mesh were randomized to receive 1.0 g intravenous Cefazolin before the incision or an equal volume of placebo. Wound infection was defined according to the criteria of Centers for Disease Control and recorded. Results were assessed using chi-square test. Results: 100 patients were included in the study. Minimum age of patients in this study was 20 and maximum 75 years with a mean of 44.06 in group A and 44.84 in group B. The total number of wound infections was 7 (7%); 2 (4%) in the antibiotic prophylaxis group and 5 (10%) in the placebo group. Statistical analysis showed no significant difference in the number of wound infections in both groups (p value=0.240). Conclusions: We conclude that in Lichtenstein inguinal hernia repair routine use of prophylactic antibiotics is not needed, as it does not significantly reduce the postoperative wound infection rates.

Antibiotic prophylaxis in neurosurgery

1984 ◽  
Vol 60 (4) ◽  
pp. 724-726 ◽  
Author(s):  
James Geraghty ◽  
Micheal Feely
Keyword(s):  
Antibiotic Prophylaxis ◽  
Randomized Trial ◽  
Infection Rate ◽  
Treated Group ◽  
Prophylactic Antibiotics ◽  
Control Group ◽  
Wound Infections ◽  
Content Type ◽  
Fine Print

✓ A randomized trial was performed to support the contention that prophylactic antibiotics can reduce the incidence of postoperative neurosurgical wound infections. The regime outlined by Malis was followed. Vancomycin and gentamicin were administered systemically just prior to surgery and streptomycin was added to the irrigating solution. Patients were randomly assigned to two groups: control and treated. The infection rate in the control group was 3.5% and in the treated group 0.5%.

Development of postoperative fibromatosis after resection of an intraspinal meningioma

1999 ◽  
Vol 90 (1) ◽  
pp. 121-124 ◽  
Author(s):  
James J. Lynch ◽  
Javad Parvizi ◽  
Bernd W. Scheithauer ◽  
William E. Krauss
Keyword(s):  
Differential Diagnosis ◽  
Desmoid Tumor ◽  
Postoperative Wound Infection ◽  
Spinal Meningioma ◽  
Wound Sepsis ◽  
Content Type ◽  
Postoperative Wound ◽  
Adult Female Patient ◽  
Fine Print ◽  
Rapid Regrowth

✓ The authors report the case of an adult female patient who developed a paraspinous thoracic fibromatosis (desmoid tumor) after undergoing resection of an intraspinal thoracic meningioma that was complicated by postoperative wound infection. To the best of the authors' knowledge, this is the first report of such a tumor occurring after resection of a spinal meningioma. Awareness of the development of postoperative fibromatosis and recognition of its association with wound sepsis is important. Although rare, this distinctive lesion should be considered in the differential diagnosis of the apparent rapid regrowth of otherwise indolent lesions including meningioma.

scholarly journals POST OPERATIVE WOUND INFECTION

2010 ◽  
Vol 17 (02) ◽  
pp. 174-179
Author(s):  
AAMIR IJAZ ◽  
M. SUHAIL AMER
Keyword(s):  
Inguinal Hernia ◽  
Hernia Repair ◽  
Antibiotic Prophylaxis ◽  
Wound Infection ◽  
Inguinal Hernia Repair ◽  
Prophylactic Antibiotics ◽  
Postoperative Wound Infection ◽  
Wound Infections ◽  
Postoperative Wound ◽  
Lichtenstein Hernia Repair

Background: The use of antibiotic prophylaxis during Lichtenstein inguinal hernia surgery is controversial, and no definitive guidelines are available in literature. Objective: To determine effects of prophylactic antibiotics in reducing the frequency of postoperative wound infection in Lichtenstein hernia repair. Study Design: Case control study. Setting: Surgical Unit II, Allied Hospital, Faisalabad.Duration: One year, between January 2007 and December 2007. Methods: Patients undergoing unilateral, primary inguinal hernia repair electively with the Lichtenstein technique using polypropylene mesh were randomized to receive 1.0 g intravenous Cefazolin before the incision or an equal volume of placebo. Wound infection was defined according to the criteria of Centers for Disease Control and recorded. Results wereassessed using chi-square test. Results: 100 patients were included in the study. Minimum age of patients in this study was 20 and maximum 75 years with a mean of 44.06 in group A and 44.84 in group B. The total number of wound infections was 7 (7%); 2 (4%) in the antibiotic prophylaxis group and 5 (10%) in the placebo group. Statistical analysis showed no significant difference in the number of wound infections inboth groups (p value=0.240). Conclusions: We conclude that in Lichtenstein inguinal hernia repair routine use of prophylactic antibiotics is not needed, as it does not significantly reduce the postoperative wound infection rates.

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