Antibiotic Prophylaxis in Gastric, Biliary and Colonic Surgery

Stone, H. Harlan; Hooper, CE; Kolb, Laura; Geheber, C E; Dawkins, Elissa

doi:10.1097/00000658-197610000-00007

Cited by 425 publications

(166 citation statements)

References 9 publications

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“…29 ' 30 Inappropriate SAP was one of the factors that increased the risk of SSI in this study. When the first antibiotic dose was administered while or after the incision was made, the risk of SSI was significantly higher than when it was administered within 30 minutes before the incision was made (OR, 3.00 [95% CI, 1.09-8.23]).…”

Section: Discussionmentioning

confidence: 64%

Prospective Nationwide Surveillance of Surgical Site Infections after Gastric Surgery and Risk Factor Analysis in the Korean Nosocomial Infections Surveillance System (KONIS)

Kim

Song

et al. 2012

Infect. Control Hosp. Epidemiol.

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'" for the Korean Nosocomial Infections Surveillance System (KONIS)OBJECTIVE. To evaluate the risk factors for surgical site infection (SSI) after gastric surgery in patients in Korea. DESIGN. A nationwide prospective multicenter study.SETTING. Twenty university-affiliated hospitals in Korea.METHODS. The Korean Nosocomial Infections Surveillance System (KONIS), a Web-based system, was developed. Patients in 20 Korean hospitals from 2007 to 2009 were prospectively monitored for SSI for up to 30 days after gastric surgery. Demographic data, hospital characteristics, and potential perioperative risk factors were collected and analyzed, using multivariate logistic regression models.RESULTS. Of the 4,238 case patients monitored, 64.9% (2,752) were male, and mean age (±SD) was 58.8 ( ± 12.3) years. The SSI rates were 2.92, 6.45, and 10.87 per 100 operations for the National Nosocomial Infections Surveillance system risk index categories of 0, 1, and 2 or 3, respectively. The majority (69.4%) of the SSIs observed were organ or space SSIs. The most frequently isolated microorganisms were Staphylococcus aureus and Klebsiella pneumoniae. CONCLUSIONS. Male sex, inappropriate SAP, and operation-related variables are independent risk factors for SSI after gastric surgery. Infect Control Hosp Epidemiol 2012;33(6):572-580Surgical site infections (SSIs) are the leading cause of noslance system for nosocomial infections, the Korean Nosoocomial infection. The development of SSIs results in procomial Infections Surveillance System (KONIS), was devellonged hospital stay, extra costs, and increased morbidity and oped in Korea in 2006. 5 Gastric surgery was one of the most mortality. 1,2 A system for infection surveillance and to provide frequently performed surgical procedures in Korea in 2009 feedback to practicing surgeons regarding infection rates was (39.64 operations per 100,000 population); 6 when employing effective in reducing rates of SSI in previous studies. 3 ' 4 In surveillance for SSIs and risk factor analyses in Korea, gastric addition, it is important to establish the risk factors for SSI, surgery was given priority over other surgical procedures. A to prevent infectious complications after surgery by improvnumber of studies have shown that wound class, patient age, ing correctable factors.body mass index (BMI), duration of operation, laparoscopic A nationwide prospective multicenter Web-based surveilprocedure, and multiple doses of prophylactic antibiotics Affiliations:

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Section: Discussionmentioning

confidence: 64%

Prospective Nationwide Surveillance of Surgical Site Infections after Gastric Surgery and Risk Factor Analysis in the Korean Nosocomial Infections Surveillance System (KONIS)

Kim

Song

et al. 2012

Infect. Control Hosp. Epidemiol.

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“…Almost 50 years have passed since the publication of the now historic studies by Polk (1969), Nichols (1973), Stone (1976) and Condon (1979) [1][2][3][4], on the efficacy of perioperative antibiotic use for the prevention of surgical site infections (SSIs, infections of the operative incision and/or operative space) in elective surgery. Subsequent reports by the same authors, as well as by other surgeons and infectious disease specialists, largely confirmed the original findings, thus rendering perioperative antibiotic use an integral part of the contemporary standard of care, as described in clinical practice guidelines published by multiple scientific societies, national and international health organizations [5,6].…”

Section: Editorialmentioning

confidence: 99%

The Prophylactic Use of Antibiotics in Surgery

Voros

2018

Hellenic J Surg

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“…[1][2][3][4][5][6] Various risk factors for incisional SSI have been reported, including obesity, emergency operations, and poor glucose control. [7][8][9][10][11] Obesity has been identified as a risk factor for infections and wound complications after a wide variety of surgical procedures.…”

Section: S Urgical Site Infection (Ssi) Including Wound Infection (Imentioning

confidence: 99%

Novel Method of Surgical Incision Management in Patients Undergoing Colorectal Surgery

Fujii

Morita

Sutoh

et al. 2016

International Surgery

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We previously demonstrated that subcutaneous drain is effective for preventing incisional surgical site infection (SSI) in patients with thick subcutaneous fat in colorectal surgery. We have recently attempted a novel closure technique in colorectal surgery for the prevention of incisional SSI. In the current study, we described this novel method for prevention of incisional SSI and share our assessment of efficiency of this incision management in patients undergoing colorectal surgery. The procedure ''wound dressing with temporary negative pressure'' using Opsite Post-Op Visible and an Atom Multipurpose Tube, is a simple and easy method. Immediately after incisions were closed, Opsite Post-Op Visible dressing was applied over the incision site with an Atom Multipurpose catheter, and negative pressure was applied through the catheter. We analyzed the cases of 203 patients who underwent colorectal resection. In 60 cases, we performed this negative pressure system for prevention of SSI. We reviewed the clinical features of these cases treated by this novel method and found that the incisional SSI rate in patients who underwent colorectal resection was significantly reduced following the use of the new method. There were no complications in any of the cases due to DNP. This dressing with negative pressure (DNP) may lead to wound drainage and a reduction of dead space in a subcutaneous wound area. These findings indicate that the use of DNP is safe, easy, and effective for preventing incisional SSI in patients undergoing colorectal surgery. Obesity has been identified as a risk factor for infections and wound complications after a wide variety of surgical procedures. 7,8 We previously demonstrated that the risk of incisional SSI increases with obesity, and that the most useful predictor of incisional SSI is the thickness of subcutaneous fat (TSF), as evaluated by preoperative computed tomography (CT). 12 We also demonstrated that subcutaneous drain is effective for preventing incisional SSI in patients with thick subcutaneous fat in colorectal surgery.13 Subcutaneous drains are effective for wound drainage and reduce dead space in a subcutaneous wound area, which is considered to lead to a reduced risk of incisional SSI. 13 However, findings regarding the utility of subcutaneous drains in the prevention of incisional SSI remain controversial, and some studies have found that subcutaneous drains do not reduce the incidence of SSI.14-17 Our previous study also showed the possibility that subcutaneous drains would be useful only for patients with a high risk for incisional SSI and those with thick subcutaneous fat tissue, but not for all patients undergoing colorectal surgery.13 A possible reason is that subcutaneous drain appears to be unnecessary or rather harmful in patients without thick subcutaneous fat tissue, since the drain is a foreign substance for the human body. Thus, we have recently attempted a novel closure technique in surgery for colorectal surgery for the prevention of incisional SSI. The procedure, w...

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Antibiotic Prophylaxis in Gastric, Biliary and Colonic Surgery

Cited by 425 publications

References 9 publications

Prospective Nationwide Surveillance of Surgical Site Infections after Gastric Surgery and Risk Factor Analysis in the Korean Nosocomial Infections Surveillance System (KONIS)

Prospective Nationwide Surveillance of Surgical Site Infections after Gastric Surgery and Risk Factor Analysis in the Korean Nosocomial Infections Surveillance System (KONIS)

The Prophylactic Use of Antibiotics in Surgery

Novel Method of Surgical Incision Management in Patients Undergoing Colorectal Surgery

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