Antimicrobial prophylaxis for surgery: An advisory statement from the National Surgical Infection Prevention Project

Bratzler, Dale W.; Houck, Peter M.

doi:10.1016/j.amjsurg.2005.01.015

Cited by 1,004 publications

(1,001 citation statements)

References 65 publications

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“…1 Of particular concern for patients undergoing cardiac surgery are deep sternal wound infections or mediastinitis after procedures with a median sternotomy. Sternal wound infections occur in 5% of all children after median sternotomy.…”

Section: Resultsmentioning

confidence: 99%

Cefuroxime Pharmacokinetics in Pediatric Cardiovascular Surgery Patients Undergoing Cardiopulmonary Bypass

Knoderer

Saft

Walker

et al. 2011

Journal of Cardiothoracic and Vascular Anesthesia

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Section: Resultsmentioning

confidence: 99%

Cefuroxime Pharmacokinetics in Pediatric Cardiovascular Surgery Patients Undergoing Cardiopulmonary Bypass

Knoderer

Saft

Walker

et al. 2011

Journal of Cardiothoracic and Vascular Anesthesia

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“…Published guidelines direct practitioners to administer antibiotics within 60 min of skin incision to minimize the risk of SSI. 8 The risk of SSI has been shown to increase dramatically when antibiotics are given more than two hours before surgery (OR 6.7; 95% CI 2.9 to 14.7) or after the incision (OR 5.8; 95% CI 2.6 to 12.3). 9 Despite this, populationbased studies have shown that timing for antibiotic administration remains poor.…”

Section: Perioperative Antibioticsmentioning

confidence: 99%

“…9 Despite this, populationbased studies have shown that timing for antibiotic administration remains poor. Using data from the National Surgical Infection Prevention Project, Bratzler et al 10 found as few as 55.7% of patients in participating hospitals across the United States were receiving preoperative antibiotics in a timely fashion.…”

Section: Perioperative Antibioticsmentioning

confidence: 99%

“…Patients will often report symptoms attributed to penicillin use that do not represent true allergic reactions. 8 A focused history can help to identify those patients with true allergies who require a modification to their antibiotic regimen. Where gram positive pathogens represent the most common infective agent, substitution of a cephalosporin with vancomycin or clindamycin is recommended.…”

Section: Perioperative Antibioticsmentioning

confidence: 99%

“…Where gram positive pathogens represent the most common infective agent, substitution of a cephalosporin with vancomycin or clindamycin is recommended. 8 Modification is also required for patients known to be colonized with MRSA. Again, vancomycin is indicated in this case.…”

Section: Perioperative Antibioticsmentioning

confidence: 99%

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Review article: The anesthesiologist’s role in the prevention of surgical site infections

Forbes

McLean

2012

Can J Anesth/J Can Anesth

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Purpose To highlight the role of anesthesiologists in the prophylaxis of surgical site infections (SSIs) and to recognize the central role they play in quality improvement initiatives for the prevention of SSIs. Source The medical literature was searched with a focus on three interventions affecting the risk of SSIs: preoperative antibiotic administration, perioperative normothermia, and perioperative hyperoxia. The literature was also searched for examples of initiatives in patient safety and quality improvement that highlight the role of anesthesiologists in preventing SSIs. Principal findings The timely administration of preoperative antibiotics and the maintenance of perioperative normothermia have been shown to reduce the risk of SSI significantly. Perioperative hyperoxia in the prevention of SSIs remains controversial but may improve outcomes in specific subsets of the surgical population. Initiatives in quality improvement show the challenges faced by many centres to improve upon these processes of care, but they also highlight the role of anesthesiologists as champions in the multidisciplinary efforts for the prevention of SSIs. Conclusions Anesthesiologists are responsible for many of the processes of care shown to impact the risk for SSIs, and they play an important role in the prevention of SSIs.

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Methicillin-Resistant Staphylococcus aureus–Positive Surgical Site Infections in Face-lift Surgery

Zoumalan

Rosenberg

2008

Archives of Facial Plastic Surgery

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To determine the incidence of methicillinresistant Staphylococcus aureus (MRSA)-positive surgical site infections after face-lift surgery and to discuss the screening, prevention, and treatment of such infections. Methods: The patient charts of 780 patients who underwent a deep-plane rhytidectomy between 2001 and 2007 were reviewed for postoperative wound infections. Culture results and sensitivities were recorded. To our knowledge, this is the first study that documents MRSA-positive surgical site infections after face-lift surgery. Results: Five of 780 patients (0.6%) who underwent facelift surgery by the senior surgeon had postoperative surgical site infections. Four of the 5 patients had cultures that were positive for MRSA. Two of these patients (0.3%) required hospitalization and had collections that had to be opened or drained and developed wound breakdown. Both patients eventually responded to wound care along with intravenous and then oral antibiotic therapy. The other 2 MRSA-infected patients responded to oral antibiotic therapy and local wound care alone. The 2 complicated infections occurred on postoperative days 5 and 8. These 2 patients were the only ones among the 5 patients with positive cultures who had known recent contact with another physician or a hospital. All infections occurred in the year 2006, with 3 patients experiencing infection in the last 4 months of the year. Herein, we describe the incidence and sequelae of MRSA infections and colonization. The 2 major different subsets of MRSA are community-acquired MRSA and health care-associated MRSA. Surgical site infections that are positive for MRSA blur this division, which affects many aspects of the course of disease and treatment. We also discuss strategies for screening, preventing, and treating MRSA surgical site infections. Conclusions: Methicillin-resistant S aureus-positive surgical site infection is an increasingly problematic issue in all surgical fields. In the future, MRSA-positive infections will be more prevalent and will require well-developed screening, prevention, and treatment strategies.

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Antimicrobial prophylaxis for surgery: An advisory statement from the National Surgical Infection Prevention Project

Cited by 1,004 publications

References 65 publications

Cefuroxime Pharmacokinetics in Pediatric Cardiovascular Surgery Patients Undergoing Cardiopulmonary Bypass

Cefuroxime Pharmacokinetics in Pediatric Cardiovascular Surgery Patients Undergoing Cardiopulmonary Bypass

Review article: The anesthesiologist’s role in the prevention of surgical site infections

Methicillin-Resistant Staphylococcus aureus–Positive Surgical Site Infections in Face-lift Surgery

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