Abstract

BSTRACT:
BACKGROUND:
Surgical site infection is one of the commonest complications after surgical operations and the use
of antibiotics in preventing or reducing infection is associated with many problems.
OBJECTIVE:
To evaluate the use of peri- operative prophylactic antibiotics in preventing or reducing surgical
site infection in different types of operations
PATIENTS AND METHODS:
This prospective study was conducted on(560) patients from June 2002 to January 2007 in general
surgical department in Baghdad teaching hospital.
The patients were divided into( 3) groups according to the type of operation; clean operations
which included 200 patients, clean-contaminated operations which included 160 patients and
contaminated operations which included 200 patients) and they were further subdivided into 2
groups, group A of patients were treated with peri operative prophylactic Cefotaxime antibiotic
while the group B patients were treated with therapeutic dose of the same antibiotic for prolonged
duration (5 days).
Those patients were followed up for 4 weeks after operation and when signs of wound infection
appeared, swab for culture and sensitivity was taken to determine the type of bacteria, and effective
antibiotics against them.
RESULT:
Result showed that (3) patients (3%) in clean surgery developed wound infection when using
perioperative regimen as compared to( 2) patients (2%) when using therapeutic regimen. In clean
contaminated wounds infection appeared in (5) patients (5%) in patients using prophylactic or
postoperative regimen while in contaminated wounds, (11) patients (11%) developed wound
infection when using perioperative regimen as compared to( 6) patients (6%) who developed
wound infection in patients using postoperative antibiotics.
Statistically, there is little difference in effectiveness of the two regimens (A and B) in both group(
1) and( 2) operations but in the group( 3) operations, although prophylactic antibiotic regimen
reduced the infection rate to 11% but it was not as effective as the therapeutic regimen in reducing
wound infection (6%) .
CONCLUSION:
Postoperative antibiotics should be resisted in clean and clean contaminated operations instead
perioperative antibiotics can be used, and prolonged postoperative antibiotics should be used
only in contaminated operations