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Operations without sepsis remain an unfulfilled goal since the introduction of antisepsis by Lister who made it a realistic objective. 1 Wound infection accounts for nearly one-fourth of the total number of nosocomial infections. 2 Even though the complete elimination of wound infection is not possible, a reduction of the wound infection rate to a minimum level could have marked benefits in terms of both patient comfort and resources used. METHODSA total of 120 patients were randomized into two groups of 60 each. Controls Group A received single dose intravenous ceftriaxone (1 gm), whereas test Group B received intra-incisional ceftriaxone given subcutaneously along the incision line preoperatively with single dose intravenous ceftriaxone (1 gm). Patients in both groups received routine post-operative antibiotics in dirty, clean contaminated and contaminated cases. An intraoperative swab was taken and sent to Department of Microbiology where they inoculated in Blood agar and MacConkey's medium. The patients were seen on daily basis till the day of discharge from the hospital and followed up as outpatient basis once a week for 30 days. Discharge from patient's wound were collected and sent to Department of Microbiology for processing. RESULTSThe rate of surgical site infection was more in Group A than Group B (25% vs. 8.33%). In Group B no cases of SSI was found in clean, clean contaminated and dirty group and 5 cases of SSI out of 24 were found in contaminated cases (20.83%), whereas in Group A all wound class had SSI. Among the organisms cultured from various swabs taken, there was predominance of E. coli (75%). CONCLUSIONPre-operative intra-incisional antibiotics reduce the rate of SSI in all wound classes. The higher concentration achieved at the incision site by the intra-incisional route theoretically makes it a better mode of administering prophylactic antibiotics.
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