Surahio Abdul Rashid, Khan Ashar Ahmad, Farooq Main Usman, Fatima Iffat
Department of General Surgery, Al-Noor Specialist Hospital Holly, Makkah, Saudi Arabia.
J Ayub Med Coll Abbottabad. 2010 Oct-Dec;22(4):92-5.
Infection is a great problem in surgery and is encountered by all surgeons by nature of their craft; they invariably impair the first line of host defence. Bacteria may enter the wound during or after the operation and may be of endogenous or exogenous origin. The objective of this study was to determine the effectiveness of preoperative antibiotic prophylaxis in reduction of postoperative wound infection in clean and clean contaminated procedures and to compare the cost of antibiotic prophylaxis in both groups.
This was a prospective study done on patients in General Surgery Department, Al-Noor Specialist Hospital, Holly Makkah, Saudi Arabia from 1st April 2006 to 30th March 2007. Total 400 patients were divided into 2 groups of 200 patients each: Group-A received single dose antibiotic prophylaxis, and Group-B received 3 doses of antibiotic therapy. Only clean and clean contaminated procedures were included and results were compared.
In Group A, clean procedures (Group-Al) were 110, and clean contaminated (Group-A2) were 90 patients. In clean procedure, rate of infection was 5 out of 110 (4.54%) and in clean contaminated procedures it was 3 out of 90 (3.33%). In Group B, in clean procedures (Group-B1), rate of infection was 7 out of 90 (7.77%), while in clean contaminated procedures (Group-B2) it was 9 out of 110 (8.18%) patients. Over all wound infection rate after single dose antibiotic prophylaxis was 4% in both procedures and 8% after 3-dose antibiotic therapy.
Single dose antibiotic prophylaxis is as effective as 3-dose therapy in clean and clean contaminated procedures to prevent wound infection and is cost-effective.
感染是外科手术中的一个重大问题，所有外科医生因其职业性质都会遇到；手术不可避免地会损害宿主的第一道防线。细菌可能在手术期间或术后进入伤口，其来源可能是内源性的或外源性的。本研究的目的是确定术前抗生素预防在减少清洁和清洁-污染手术术后伤口感染方面的有效性，并比较两组抗生素预防的成本。
这是一项前瞻性研究，于2006年4月1日至2007年3月30日在沙特阿拉伯麦加圣城努尔专科医院普通外科对患者进行。总共400名患者被分为两组，每组200名患者：A组接受单剂量抗生素预防，B组接受3剂量抗生素治疗。仅纳入清洁和清洁-污染手术，并比较结果。
A组中，清洁手术（A1组）有110例患者，清洁-污染手术（A2组）有90例患者。在清洁手术中，感染率为110例中的5例（4.54%），在清洁-污染手术中为90例中的3例（3.33%）。在B组中，清洁手术（B1组）的感染率为90例中的7例（7.77%），而在清洁-污染手术（B2组）中为110例中的9例（8.18%）。单剂量抗生素预防后，两种手术的总体伤口感染率均为4%，3剂量抗生素治疗后为8%。
在清洁和清洁-污染手术中，单剂量抗生素预防在预防伤口感染方面与3剂量治疗同样有效，且具有成本效益。
