scholarly journals ANTIBIOPROPHYLAXIS AND ANTIBIOTHERAPY IN ABDOMINAL SURGERY – SHORT REVIEW

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.

scholarly journals Feasibility and diagnostic accuracy of Telephone Administration of an adapted wound heaLing QuestiONnaire for assessment for surgical site infection following abdominal surgery in low and middle-income countries (TALON): protocol for a study within a trial (SWAT)

Trials ◽  
2021 ◽  
Vol 22 (1) ◽  
Author(s):  
◽  
James Glasbey ◽  
Victoria Adeyeye ◽  
Adesoji Ademuyiwa ◽  
Alisha Bhatt ◽  
...  
Keyword(s):  
Wound Healing ◽  
Abdominal Surgery ◽  
Diagnostic Accuracy ◽  
Surgical Site Infection ◽  
Hospital Discharge ◽  
Site Infection ◽  
Middle Income ◽  
Middle Income Countries ◽  
Wound Assessment ◽  
Study Within A Trial

Abstract Background Surgical site infection is the most common complication of abdominal surgery, with a global impact on patients and health systems. There are no tools to identify wound infection that are validated for use in the global setting. The overall aim of the study described in this protocol is to evaluate the feasibility and validity of a remote, digital pathway for wound assessment after hospital discharge for patients in low- and middle-income countries (LMICs). Methods A multi-centre, international, mixed-methods study within a trial, conducted in two stages (TALON-1 and TALON-2). TALON-1 will adapt and translate a universal reporter outcome measurement tool (Bluebelle Wound Healing Questionnaire, WHQ) for use in global surgical research (SWAT store registration: 126) that can be delivered over the telephone. TALON-2 will evaluate a remote wound assessment pathway (including trial retention) and validate the diagnostic accuracy of this adapted WHQ through a prospective cohort study embedded within two global surgery trials. Embedded community engagement and involvement activities will be used to optimise delivery and ensure culturally attuned conduct. TALON-1 and TALON-2 are designed and will be reported in accordance with best practice guidelines for adaptation and validation of outcome measures, and diagnostic test accuracy studies. Discussion Methods to identify surgical site infection after surgery for patients after hospital discharge have the potential to improve patient safety, trial retention, and research efficiency. TALON represents a large, pragmatic, international study co-designed and delivered with LMIC researchers and patients to address an important research gap in global surgery trial methodology.

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 To study the effectiveness of prophylactic use of ceftriaxone (single dose) in caesarean section in low risk patients in a tertiary care center, Moradabad, India

2017 ◽  
Vol 5 (12) ◽  
pp. 5278
Author(s):  
Ruby Kumari ◽  
Arti Sharma ◽  
. Sheetal ◽  
Pratibha Roy ◽  
. Anupriya
Keyword(s):  
Single Dose ◽  
Caesarean Section ◽  
Surgical Site Infection ◽  
Care Center ◽  
Tertiary Care ◽  
Infectious Complications ◽  
Low Risk ◽  
Tertiary Care Center ◽  
Site Infection ◽  
Risk Patients

Background: There is increasing incidence of caesarean section throughout the world. As caesarean section is associated with infectious complications which increase the rate of morbidity and mortality of mothers. For prevention of infectious complications antibiotics are used but careless use of antibiotics increasing incidence of antibiotic resistance. Many guidelines and studies recommend single dose antibiotic prophylaxis for women undergoing elective or non-elective caesarean section. The aim of this study was to assess the effectiveness of Ceftriaxone as prophylactic antibiotic (single dose) in caesarean section in low risk patients.Methods: A Prospective single blind study was carried out in the department of obstetrics and gynaecology, TMMC and RC Moradabad, a tertiary care center, in all low risk patients underwent for Elective and Emergency Lower segment caesarean section for 1 year from 1st June 2015 to May 2016 on 110 patients. Data was collected and analyzed by percentage and proportion.Results: Prevalence of caesarean section was maximum in women of 26-35years age group (52.72%),about 67.27% was emergency LSCS, most common indication of caesarean section was Fetal distress (29.09%),refusal for vaginal delivery after caesarean section (10.90%) was one of the cause for increasing rate of repeat caesarean section, 41.81% women in labour,72.27% cases were with intact membrane, in 9.09% cases, antibiotic had to change in post-operative period due to urinary tract infection and surgical site infection, most common post-operative complication was superficial surgical site infection with purulent discharge (2.72%). No major life-threatening complication occurred.Conclusions: Single dose of Ceftriaxone is effective for prevention of post-caesarean infectious complication.

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

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. 

Circular pOlyethylene drape in preVEntion of suRgical site infection (COVER Trial): Study protocol of a randomized controlled trial

2018 ◽  
Author(s):  
Ri Na Yoo ◽  
Hyung Jin Kim ◽  
Jae Im Lee ◽  
Won-Kyung Kang ◽  
Bong-Hyeon Kye ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Abdominal Surgery ◽  
Surgical Site Infection ◽  
Controlled Trial ◽  
Dropout Rate ◽  
Site Infection ◽  
Gi Tract ◽  
Randomized Controlled ◽  
Wound Protector ◽  
Open Abdominal Surgery

Abstract Background: Surgical site infection (SSI) after abdominal surgery is still a significant morbidity associated with an increased socioeconomic burden and poor quality of life. SSI prevalence rates as high as 40% in cases of fecal contamination have been reported; however, current methods to reduce SSI are limited to elective abdominal surgery. Further evaluation of preventive measures for reducing SSI is necessary. Methods/design: The COVER trial investigates whether the application of a dual-ring circular plastic wound protector reduces the rate of SSI in patients undergoing open abdominal surgery related to the gastrointestinal (GI) tract, regardless of the type of wound classified by the Center for Disease Control (CDC). The COVER trial is a multicenter, randomized controlled clinical trial with two parallel arms – one using a wound protector and the other using conventional surgical dressing gauze. The primary outcome will measure the rate of SSI in two groups. Statistical analysis of the primary end point will be based on the intention-to-treat population. The sample size is determined to achieve a study power of 80% at 95% 2-sided confidence limits. Considering a dropout rate of up to 5%, a total of 458 patients, 229 patients in each group, will be enrolled in this study. Discussion: The COVER trial will provide high-quality evidence for using a circular polyethylene drape in open abdominal surgery for the GI tract in all types of wound. The design of the trial will deliver high external validity and clinical significance. Trial registration: The trial protocol was registered at ClinicalTrials.gov (NCT 03170843) on May 31, 2017. https://clinicaltrials.gov/ct2/show/NCT03170843?term=NCT+03170843&rank=1 Keywords: Circular polyethylene drape, Abdominal surgery, Gastrointestinal tract, Surgical site infection, Randomized controlled trial

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).

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