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.

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.

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.

scholarly journals Pengaruh Pemberian Antibiotik Profilaksis Sefazolin, Seftriakson dan Antibiotik Seftriakson Sebelum dan Sesudah Operasi Terhadap Infeksi Luka Pasca Operasi

2020 ◽  
Vol 4 (1) ◽  
pp. 77-86
Author(s):  
Herti Marni ◽  
Dovy Djanas ◽  
Hafni Bachtiar
Keyword(s):  
Wound Infection ◽  
Univariate Analysis ◽  
Prophylactic Antibiotic ◽  
Prophylactic Antibiotics ◽  
Bivariate Analysis ◽  
Control Group ◽  
Postoperative Wound Infection ◽  
Control Group Design ◽  
Postoperative Wound ◽  
Before And After

Objective : To determine the effect of giving prophylactic antibiotic ceftriaxone and cefazolin and giving ceftriaxone before and after surgery to the risk of postoperative wound infection in postoperative patients.Method: This study was an experimental study with a post test control group design that looked at the differences in the effect of administration of ceftriaxone, cefazolin, and ceftriaxone before and after surgery on the risk of postoperative wound infection. The population in this study were patients planned for surgery in the Obstetric and Gynelologic Departement of Dr. M. Djamil General Hopital, Padang. The number of samples used by 30 people with a group of 10 people each group. The study began in August until the number of samples was fulfilled. Univariate analysis was used to see the frequency, percentage, mean, and standard deviation. Bivariate analysis using Chi-square test with 95% CI (α <0.05) was used to see differences in the effect of the three antibiotic procedures.Results: There were no cases of postoperative wound infection based on the three procedures used. There was no difference in the effect of prophylactic antibiotics in postoperative infections. Conclusion: There was no difference in the effect of the three procedures for prophylactic antibiotics in postoperative infections.Keywords: Prophylactic Antibiotics, Surgical Wound Infections, Cefazolin, Ceftriaxone, Superficial incisional SSI

Outcome of Single Dose Prophylactic Antibiotic in Carpal Tunnel Release Surgery

2020 ◽  
Author(s):  
Inayat Ali Khan
Keyword(s):  
Single Dose ◽  
Wound Infection ◽  
Carpal Tunnel ◽  
Carpal Tunnel Release ◽  
Prophylactic Antibiotic ◽  
Postoperative Wound Infection ◽  
Study Objective ◽  
Postoperative Wound ◽  
Compressive Neuropathy ◽  
Carpal Tunnel Release Surgery

Background: It has been well documented that administering a prophylactic antibiotic brings down the rate of postoperative wound infection very strikingly in carpal tunnel release (CTR) surgery. Carpal tunnel syndrome (CTS) is definitely a compressive neuropathy of the upper limbs, which is both benign and frequent. The study objective was to determine the postoperative wound infection rate in carpal tunnel release surgery after having administered a single dose of a prophylactic antibiotic. Methods: This cross-sectional study was carried out at the department of Neurosurgery, Dammam Medical Complex-Saudi Arabia. The study was based on 122 patients who were operated for carpal tunnel release procedures at the centre. Pre-operatively all patients were subjected to nerve conduction studies (NCS) to document CTS as the definitive diagnosis. As a routine, every patient was administered intravenous loading dose of cefuroxime (1.5g) at least 1 hour prior to surgery. All patients were treated as day care cases and were discharged after a few hours of surgery. On discharge, no further antibiotics were administered. Their wounds were examined. Results: Superficial redness over the site of incision was noted in three of the patients and wound infection in two others. These two patients improved with oral antibiotics. Not a single patient needed re-exploration. Conclusion: The current study showed that this is an efficacious and a very safe protocol to follow. Assuming the fact that the incidence of surgical site infection (SSI) in CTR surgery is low, the results were not different when compared to the results from other centres.

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.

scholarly journals A study of preoperative, intra-operative and postoperative factors responsible for postoperative wound infection

2017 ◽  
Vol 4 (5) ◽  
pp. 1569
Author(s):  
Shobha S. Nisale ◽  
Meghraj Chawada ◽  
Ganesh K. Kharkate ◽  
Sudhir B. Deshmukh
Keyword(s):  
Wound Infection ◽  
Care Center ◽  
Hospital Environment ◽  
Initial Assessment ◽  
Postoperative Wound Infection ◽  
Surgical Wound ◽  
Postoperative Wound ◽  
Health Care Center ◽  
Duration Of Surgery ◽  
Operative Findings

Background: Many factors affect the incidence of surgical wound infection, in addition to the surgeon’s skill and the hospital environment. Host attributes, such as age over 60 years, diabetes mellitus, malignant disease, obesity, malnutrition, length of preoperative stay or pre-existing infection may influence risk, as may such operation characteristics as site, urgency, duration and time of skin shaving. Objective was to study the preoperative, intra-operative and postoperative factors responsible for postoperative wound infection.Methods: This descriptive study was designed to study the problem of postoperative wound infection at tertiary health care center at rural set up over a period of two years during 2014 to 2016. Initial assessment of intra operative findings divided these cases into clean, clean contaminated and contaminated cases.Results: As the length of pre-operative stay increased, the occurrence of SSIs increased. As the duration of post operative hospital stay increased, the occurrence of SSIs also increased. The occurrence of SSI increased as the quality of surgical wound deteriorated. As the duration of surgery increased, the occurrence of SSIs increased. It was found that the order of surgery was not related to occurrence of SSIs. It was found that the rate of SSI was more (21.55%) when the drain was used in comparison to only 8.04% when the drain was not used. The most common organism found to cause SSIs was staphylococcus aureus in 33.07% of cases.Conclusions: Slightly low incidence of SSIs in our study may be attributed to the better infection control practices though it must be concluded that more stringent aseptic measures including rational antibiotic policy will be contributory in lowering the SSI rate further.

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