What’s New in Infection on Surgical Site and Antibioticoprophylaxis in Surgery?

Abstract

Introduction: Infection of the surgical site is the common complication, with significant rates of morbidity and mortality, representing a considerable economic problem for the health system. Objective: To carry out a narrative review of the literature on surgical site infection and the principles of antibiotic prophylaxis to update the knowledge of its use in surgery. Method: Medline, Ovid, Google Scholar, National Library of Medicine (PubMed), Cochrane and SciELO were used for the research. The keywords used were “anti-bacterial agents”; “antibioticoprophylaxis” AND “surgical wound infection”. The inclusion criteria were articles of recent publication, with full texts available and performed in humans. Result: A total of 29 articles were evaluated and selected according to the eligibility criteria. Conclusion: Infection of the surgical site is the most common postoperative complication. The key point of its prevention is the combination of several interventions that aim to reduce risk factors, such as: compliance with the new guidelines of the Center for Disease Control and Prevention; the principles of the use of prophylactic antibiotics; factors and risk index of the surgical site; administration time; duration and dosage of antibiotics. These data are available in this article.

Risk Factors for Surgical Wound Infection After Elective Laparoscopic Cholecystectomy

“…There are a growing number of results that do not demonstrate a significant correlation between ABP in low-risk procedures and a reduction in infection rates 2 , 5 , 7 , 8 , 19 , 20 , 24 , 26 , 27 , 28 , 30 , 33 . However, there are also studies that point to a protective effect of antibiotics, leading to uncertainty 4 , 14 , 17 , 23 , 31 .…”

“…Wound infection (WI) is one of the most common postoperative complications and its incidence depends on multiple factors, from the surgical and postoperative environment to the type of procedure and patient profile 4 . Cholecystectomy is one of the most performed procedures currently, and the laparoscopic method has been replacing the open procedure as it is less invasive, with a consequent lower risk of infection, shorter hospital stay, and faster recovery 32 .…”

“…According to the hospital’s own Antibiotic Prophylaxis Protocol, the prophylactic use of antibiotics is recommended for open cholecystectomy and high-risk laparoscopic cholecystectomy (LC) (high-risk factors include bile spillage, acute cholecystitis or pancreatitis, jaundice, pregnancy, use of intraoperative cholangiography, conversion to open surgery, immune suppression, and prosthesis implantation) 9 . However, as certain risk factors cannot be predicted, it is customary among surgeons to perform antibiotic prophylaxis (ABP) for any cholecystectomy, even those considered to be of low risk 1 , 4 .…”

Postoperative infections: a preventable calamity

“…The organisms involved in the infection are generally endogenous to the patient and come from the skin or any body part that has been opened. It is the most common post surgical complication, with increased morbidity and mortality [3] . In general surgery, reported rates of post surgical complications range from 6% to 44% [4] .…”

“…These infections are a common type of healthcare associated infections and frequent complication of hospitalization. They are responsible for prolonged hospital stay, increased admissions in intensive care units, readmission in hospitals after surgery, increased surgery costs, and delays to adjuvant systemic therapy [3,5] . The increased morbidity and costs associated with these postoperative complications motivate healthcare professionals to be vigilant in recognizing risk factors arising from patient comorbidities or circumstances of surgery [2] .…”