One dose of preoperative, intravenous, prophylactic antibiotics significantly lowers postoperative infection rate in septoplasty—a study of 772 operations

Abstract

Objectives: Postoperative infection is the most common complication after septoplasty. Pre-or postoperative prophylactic antibiotics are commonly used, although no official guidelines exist. Design:We retrospectively collected data on postoperative infections from 772 septoplasties performed in 2015, 2016 and 2018, and classified the infections according to surgical site infection (SSI) criteria by the Centers for Disease Control and Prevention (CDC). We evaluated the infections according to antibiotic use (preoperative or postoperative, both, or none) and accounted for patient and surgical confounding factors.We compared the results with three previous studies from our department to find out the trend in the occurrence of postoperative infections and in the use of antibiotics.Results: Twenty-nine cases (3.8%) fulfilled CDC infection criteria. Any kind of antibiotic prophylaxis reduced the risk of SSI (p = .018). One dose of intravenous cefuroxime before incision was the most effective preventive measure (p = .045). We found no significant effect of postoperative antibiotics. However, postoperative antibiotics lowered the infection rate to 1.8% compared to 6.1% among those not treated with any antibiotics. The only other factor reducing the risk of SSI was local anaesthesia compared with general anaesthesia. Conclusion:Preoperative antibiotic prophylaxis effectively reduced postoperative infection rate after septoplasty.

Evaluate Functional Outcomes of Postoperative Septoplasty with and Without Splints and Packing

“…There is uniform agreement that postoperative pain is increased by their use [2,7,9]. According to some studies, Splints were shown to offer no additional help in stabilizing the septum postoperatively and finally, there is the very slight but definite risk of developing the toxic shock syndrome [7,14,15,16].…”

Unmet challenges in septoplasty–nordic studies from a uniform healthcare and geographical area

“…Bleeding and infection in septoplasty with or without turbinoplasty were reported to be around 3% in a large study from Poland ( 6 ). In a recent Finnish study, the number of postoperative infections were reduced from 6.1% when no antibiotics were administered to 2.6% with one dose of prophylactic cephuroxime ( 22 ). Preoperative antibiotics in septoplasty is, however, not a standard practice in the Nordic countries.…”

Prophylactic antibiotics in septoplasty with intranasal septal splints: A comparative analysis

“…3 Nonetheless, the introduction of nasal foreign bodies has raised concerns regarding the potential risk of developing local nasal infections and even toxic shock syndrome. 4,5 To minimise the risk of postoperative infections, the practice of prescribing postoperative antibiotic therapy following septoplasty with ISS placement has become increasingly common. 6 However, the available data on the efficacy of prophylactic antibiotic therapy in the presence of ISS are limited, leaving uncertainty about its true benefits.…”

“…The effectiveness of ISS, when compared to nasal packing, has been well‐established in improving nasal airflow and enhancing patient comfort, thereby driving its widespread acceptance and implementation in clinical practice 3 . Nonetheless, the introduction of nasal foreign bodies has raised concerns regarding the potential risk of developing local nasal infections and even toxic shock syndrome 4,5 . To minimise the risk of postoperative infections, the practice of prescribing postoperative antibiotic therapy following septoplasty with ISS placement has become increasingly common 6 .…”