Perioperative antibiotic prophylaxis for herniorrhaphy and breast surgery

Article Abstract:

The value of treatment with antibiotics at the time of surgery was investigated in a group of 1,218 patients who underwent surgery either for repair of hernia or for various breast conditions. The antibiotic cefonicid was given in a single injection approximately one-half hour before surgery. Studies both in humans and animals have established that preventive treatment with antibiotics can reduce the number of surgical infections, particularly in surgery of the gut, where the surgical field may be contaminated by the individual patient's own (primarily fecal) bacteria. The value of antibiotics in surgery on areas of the body that are relatively aseptic was studied. The patients were randomly divided into two groups: the experimental group received cefonicid, while the control group received an inactive placebo. The experimental group had 48 percent fewer infections overall than the placebo group. Women who underwent breast surgery and were treated with the antibiotic had an infection rate of 6.6 percent, compared with the placebo group, which had a 12.2 percent rate of infection. Treated patients who had repairs of either inguinal (groin) or femoral (thigh) hernias experienced a 2.3 percent infection rate, significantly lower than the 4.2 rate of infection in the control group. Antibiotic treatment is seen to be beneficial in controlling surgical infections in clean areas of the body where the source of infection is likely to be biologic contamination of the surgical area by organisms on the skin or from the environment. Although formal cost analysis was not performed, the following cost data are presented. The cost of the course of antibiotics before surgery is approximately $10.00, as opposed to $178 for treating breast infections and $539 for hernias. For every 1,000 patients who undergo hernia repair, antibiotics will prevent 19 cases of infection; for breast surgery antibiotic treatment will prevent 56 infections. (Consumer Summary produced by Reliance Medical Information, Inc.)

Antibiotics, Surgery, Breast, Hernia, Hernia repair, Breast surgery, Cefonicid

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Prevention of surgical-wound infections

Article Abstract:

Supplemental oxygen during and after surgery may reduce the risk of postoperative wound infections. Five percent of all surgical patients develop a surgical wound infection. In patients having colorectal surgery, the figure is even higher at 10% to 20%. A 1999 study showed that patients who received 80% oxygen had half the risk of a surgical wound infection The oxygen was delivered through a face mask during surgery and for two hours afterward. Wound infections can also be prevented by giving patients antibiotics and using ultraclean air in the operating room.

Editorial

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Early goal-directed therapy in the treatment of severe sepsis and septic shock

Article Abstract:

Therapy that improves the delivery of oxygen to the body may reduce mortality rates in patients with septic shock, according to a study of 263 patients. Septic shock occurs when the body does not get enough oxygen, which can cause multiple organ failure.

Care and treatment, Septic shock

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