Timing of Antibiotic Prophylaxis in Tourniquet Surgery

American College of Foot and Ankle Surgeons’ Clinical Consensus Statement: Perioperative Prophylactic Antibiotic Use in Clean Elective Foot Surgery

“…For surgery involving bone, hardware, or prosthetic joints, the studies specific to foot and ankle surgery did not provide sufficient evidence to change our current clinical consensus (9)(10)(11)(12)(13)(14). Of the 4 included studies relating to use of prophylactic antibiotics and incidence of infection (Table 1), the panel considered 2 studies to be level IV evidence, 1 study to be level III evidence, and 1 study to be level II (Table 3) (17).…”

A Clinical Perspective on Musculoskeletal Infection Treatment Strategies and Challenges

“…68 Proper surgical technique, including skin preparation, draping, surgical scrub, and meticulous soft-tissue management, is critical to the prevention of infections. 80,81 However, postoperative outpatient oral antibiotic treatment remains controversial. Skin preparation with chlorhexidine and alcohol prep has been shown to be the most effective combination for reducing preoperative bacterial loads, although many other combinations have been proposed.…”

Back to Basics: Preventing Surgical Site Infections

“…A Cochrane review 21 suggests that using a prophylactic antibiotic for patients undergoing hernia repair with mesh reduces the risk of SSIs; however, prophylactic antibiotics did not reduce the risk of SSIs when mesh was not used. Akinyoola et al 22 conducted one randomized controlled trial in Nigeria that suggested that administering antibiotics after tourniquet inflation rather than before inflation resulted in a decrease in SSIs. A 2012 Cochrane review and a 2013 randomized controlled trial collectively suggest that prophylactic antibiotics may reduce the risk of SSIs during breast cancer surgery 23,24 .…”