Perioperative cefamandole prophylaxis against infections.

Gatell, Josep M.; García, Sergio; Lozano, Luisa Seco; Soriano, E; Ramón, R; SanMiguel, J G

doi:10.2106/00004623-198769080-00012

Cited by 50 publications

(19 citation statements)

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“…In this study of 712 patients, Gatell et al compared the efficacy of 5 doses of cefamandole to a single preoperative dose. 13 However, the multiple-dose group received an additional 2-g dose of cefamandole, possibly intraoperatively. The antibiotic schedule consisted of cefamandole 2 g 30 minutes before and 2 hours after the start of the operation, plus 1-g doses at 8, 14, and 24 hours thereafter.…”

Section: Discussionmentioning

confidence: 99%

“…9,10,13,15 However, only 1 study within the 7 pooled trials reported a statistically significant result. 13 This trial showed a benefit to using multiple doses of prophylaxis. In the remaining 6 studies, the 95% confidence intervals included 1.0 and were not statistically significant; this was also reflected in the pooled results.…”

Section: Data Extraction and Statistical Analysismentioning

confidence: 97%

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Single- Versus Multiple-Dose Antibiotic Prophylaxis in the Surgical Treatment of Closed Fractures: A Meta-Analysis

Slobogean

Kennedy

Davidson

et al. 2008

Journal of Orthopaedic Trauma

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In the setting of closed long bone fractures, the pooled results failed to demonstrate superiority of multiple-dose prophylaxis over a single-dose strategy. The pooled estimates suggest that surgical wound infections are relatively rare events and that any potential difference in infection rates between prophylaxis strategies is likely quite small. However, because the confidence interval surrounding the pooled risk ratio spans 1.0 by such a large amount, we are unable to definitively recommend a preferred dosing regimen to prevent surgical wound infections. Although future research is required to ensure our prophylaxis decisions continue to be evidence based and cost-effective, it is unlikely that a single clinical trial will be able to provide the answer. The use of other quantitative methods, such as cost-effectiveness analysis, may be helpful in modeling an optimal prophylaxis strategy.

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Section: Discussionmentioning

confidence: 99%

Section: Data Extraction and Statistical Analysismentioning

confidence: 97%

Single- Versus Multiple-Dose Antibiotic Prophylaxis in the Surgical Treatment of Closed Fractures: A Meta-Analysis

Slobogean

Kennedy

Davidson

et al. 2008

Journal of Orthopaedic Trauma

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show abstract

“…In the operating room the skin was painted with povidone-iodine solution in water; the operative area was then isolated with sterile sheets and Covered with adhesive plastic sheeting (Steridrape). All patients received prophylactic antibiotic therapy as described previously [3] and prophylactic subcutaneous injection of heparin.…”

Section: Methodsmentioning

confidence: 99%

Bacteriological study of surgical knives: is the use of two blades necessary?

Ramón

García

Combalía

et al. 1994

Arch Orthop Trauma Surg

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Scalpel blades used in 115 operations were studied bacteriologically. In each case the knife used for skin incision was discarded immediately after the incision and a fresh knife was used to complete the operation. The scalpel blades were cultured in enriched thioglycolate and incubated at 37 degrees C. Readings were taken at 24 and 48 h. From positive cultures, colonies were isolated directly in solid media, and the germ was identified using routine tests. Results showed that there was no bacteriological evidence to justify the use of different blades for skin incision and deep dissection.

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“…The antibiotic regime and the specific procedures in which its use will be beneficial are not clearly documented . Some authors suggest using a single preoperative dose, whereas others have used multiple dosing prophylaxis . Some believe that antibiotic prophylaxis use is not justified in low‐energy closed fractures, but others recommend it for open reduction and internal fixation of all closed fractures…”

Section: Introductionmentioning

confidence: 99%