Coronary Arterial Bypass Operations without Antibiotic Coverage

Sutherland, Robert; Miller, Otis; Martinez, H.E.; Guynes, W.A.; Fyfe, Trey; Harkrider, Wayne

doi:10.1378/chest.76.2.174

Cited by 21 publications

(2 citation statements)

References 3 publications

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“…Conversely, another group found no difference in infection rate when comparing antibiotic prophylaxis to good surgical technique.228 Infection rate in another investigation where no antibiotics were used was less than 1 %. 229 This does not support the use of prophylaxis or the 21 O/O frequency of the other study. Recommendations for closed heart surgery are therefore that no antimicrobial prophylaxis be used, but rather that precepts of good technique be followed closely.…”

Section: Closed Heart Surgerymentioning

confidence: 72%

Surgical Antimicrobial Prophylaxis: Principles and Guidelines

Burnakis¹

1984

Pharmacotherapy

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Antimicrobial prophylaxis for surgical procedures is an area that is recognized as being subject to individual clinical variations. This review gives practitioners some basic principles of rational prophylaxis as defined by the medical literature. In addition, this literature is evaluated and condensed to provide clinicians with guidelines for particular procedures: obstetric, gynecologic, gastric, biliary, colonic, urologic, cardiac, thoracic, vascular, orthopedic and head and neck. Each section concludes with recommendations for the clinically most accepted prophylactic regimens. Antibiotics discussed include not only the older agents, but where good information exists, the newer cephalosporins. The suggested regimens consider efficacy, safety and cost as determinants in rational prescribing. Although research into even shorter, and perhaps more cost-effective, regimens continues, this compilation lists state-of-the-art recommendations.

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Section: Closed Heart Surgerymentioning

confidence: 72%

Surgical Antimicrobial Prophylaxis: Principles and Guidelines

Burnakis¹

1984

Pharmacotherapy

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“…Attenuation of microbial contamination in surgical wounds includes short preoperative stay, 6 " 13 showers with antiseptic solutions reducing patient colonization with typical wound pathogens such as 5. aureus, 14 careful preparation of the skin lr ' and administration of appropriate prophylactic antimicrobials. 16,17 Study of these measures disclosed no statistical difference between the infected and noninfected patients. Chlorhexidine preoperative showers were begun because of hexachlorophene's less than optimal antibacterial efficacy against gram-negative bacilli.…”

Section: Discussionmentioning

confidence: 95%

Postoperative Wound Infections Following Cardiac Surgery: Significance of Contaminated Cases Performed in the Preceding 48 Hours

1984

Infect. Control

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Postoperative wound infections following open heart cardiac surgery increased markedly after hospital relocation (7 of 77 v; 4 of 320; p = .0007). Of the multiple identified risk factors, significant patient and procedural association included prolonged operative time of infected patients (384 minutes ± 115 SD v 318 ± 67, p = .025) and operation in a room used within the previous 48 hours for a contaminated case (4/7 infected v 10/67 not infected; p = .023). Several defects were discovered in the air handling system. After appropriate changes, the infection rate decreased in the next 12 months (1 of 109; p < .02). Other concurrent surgical wound infection rates remained unchanged suggesting that defective air handling may have impacted only on the open heart cardiac surgery patients. Preceding contaminated surgery and prolonged operative time were associated with postoperative wound infections in cardiac surgery.

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Study of cardiothoracic wound infection at St. Thomas' Hospital

Farrington

Webster

Fenn

et al. 1985

Journal of British Surgery

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Wound infection occurred after 14.3 per cent of 433 open heart operations. In 309, saphenous veins were harvested for coronary artery bypass grafting (CABG) and 8.7 per cent of sternal wounds and 12.9 per cent of leg wounds were infected. Only 1.6 per cent of the remaining 124 patients who had open heart operations without leg surgery suffered sternal wound infections. In the CABG group sternal infection was theatre-related and significantly associated with length of pre-operative stay, diabetes and re-operation. Similar organisms were isolated from both leg and sternal wounds which suggest that organisms were transferred from legs to sternum with the veins. No clinically relevant cross infection was demonstrated. Skin disinfection and surgical technique seem more important than antibiotic prophylaxis in the control of these infections.

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Coronary Arterial Bypass Operations without Antibiotic Coverage

Cited by 21 publications

References 3 publications

Surgical Antimicrobial Prophylaxis: Principles and Guidelines

Surgical Antimicrobial Prophylaxis: Principles and Guidelines

Postoperative Wound Infections Following Cardiac Surgery: Significance of Contaminated Cases Performed in the Preceding 48 Hours

Study of cardiothoracic wound infection at St. Thomas' Hospital

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