Antibiotic Prophylaxis for the Prevention of Infection after Major Limb Amputation

McIntosh, James; Earnshaw, J. J.

doi:10.1016/j.ejvs.2009.01.013

Cited by 39 publications

(18 citation statements)

References 24 publications

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“…Post-procedural doses of intravenous antibiotics (up to 24 hours) are only required in defined circumstances, such as some cardiac and vascular surgeries, and lower limb amputation. [38][39][40] The 2016 Surgical National Antimicrobial Prescribing Survey found that incorrect duration was the most common factor in inappropriate post-procedural antimicrobial prescribing (73.7%). 7 Prophylaxis should not extend beyond 24 hours, regardless of the surgical procedure.…”

Section: Right Durationmentioning

confidence: 99%

Surgical antimicrobial prophylaxis

Ierano¹,

Nankervis²,

James³

et al. 2017

Aust Prescr

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Section: Right Durationmentioning

confidence: 99%

Surgical antimicrobial prophylaxis

Ierano¹,

Nankervis²,

James³

et al. 2017

Aust Prescr

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“…Severe stump wound infection is a common cause of failure of amputation and results in need for stump revision or re-amputation. This further surgical procedure exposes susceptible patients to the risk of operative surgical intervention and other serious complications [4,9]. Extremity amputation is a common life-saving procedure in the management of victims of natural disasters and mass casualties with severely injured limbs [5,6,14,19].…”

Section: Introductionmentioning

confidence: 99%

An analysis of risk factors associated with traumatic extremity amputation stump wound infection in a Nigerian setting

Omoke

Nwigwe

2012

International Orthopaedics (SICOT)

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Purpose We aimed to determine the risk factors associated with traumatic extremity amputation stump wound infection in our environment. Method This was a retrospective analysis of databases that included the entire patient population with traumatic extremity amputation seen in Ebonyi State University Teaching Hospital and Federal Medical Centre Abakaliki from January 2001 to December 2011. Result There were 63 patients studied and stump wound infection was a complication in 38 (60 %) of them. Stump wound infection rate significantly correlated with the form of amputation, i.e., a higher rate in crushing than guillotine (sharp clear-cut) amputation (80.5 vs. 22.7 % p<0.000); severity, i.e., a higher rate in major than minor amputation (80.6 vs. 33.3 % p<0.000); and limb involvement, i.e., a higher rate in lower than upper extremity amputation (71.1 vs. 60.7 % p<0.002). Haematocrit level on admission (p< 0.002), injury to hospital admission interval (p<0.012) and injury to first surgical debridement / amputation interval (p< 0.02) were all significantly related to incidence of wound infection. Multivariate analysis identified crushing amputation as an independent risk factor (p<0.009) for traumatic amputation stump wound infection. Conclusion The only independent predictor of traumatic extremity amputation stump wound infection is a crushing form of amputation; it should be accorded a high priority in interventions aimed at reducing infection rate

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“…The implementation of evidence-based guidelines for use of antimicrobials had been shown to improve the overall patient outcome. Studies [4,5] have established the efficacy of surgical antibiotic prophylaxis for reducing the risk of postoperative wound infection. Others have consistently shown an association between timely start of antibiotics for patients with serious infections and a favorable clinical outcome [6,7,8].…”

Section: Introductionmentioning

confidence: 99%

Audit of Physicians’ Adherence to the Antibiotic Policy Guidelines in Kuwait

Aly¹,

Omar

Badawy

et al. 2012

Med Princ Pract

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Objective: To audit physicians’ adherence to the local antibiotic policy guidelines in government hospitals in Kuwait. Materials and Methods: The study was a retrospective review of patient records in nine hospitals between July 1 and December 31, 2008. Clinical notes and medication charts of the latest hospital admissions were checked for antibiotic prescribing. On the audit form, aspects of the prescribed antibiotic were benchmarked to the hospital antibiotic policy guidelines to evaluate adherence. Results: Of 2,232 reviewed records, 1,112 (49.8%) patients had 1,528 antibiotic prescriptions. Patients who received antibiotics were significantly younger than those who did not (median age: 26.3 vs. 29.8 years, p < 0.001) and their hospital stay was significantly longer (median: 4 vs. 2 days, p < 0.001). The choice of an antibiotic was appropriate and matched the policy in 806 (52.7%) prescriptions. Of such appropriate antibiotics, adherence to route of administration was observed in 768/806 (95.3%), to dose in 758 (94%), to frequency in 746 (92.6%) and to duration in 608 (75.4%). Full adherence to all aspects of antibiotic choice, dose, route, frequency and duration was achieved in 464 (30.4%) prescriptions. In 382 (25%), the antibiotics administered were not indicated. Conclusion: There was low adherence to the local antibiotic policy guidelines. Physicians’ antibiotic prescribing practices should be optimized. Adherence to, and update of, the policy is recommended.

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Antibiotic Prophylaxis for the Prevention of Infection after Major Limb Amputation

Cited by 39 publications

References 24 publications

Surgical antimicrobial prophylaxis

Surgical antimicrobial prophylaxis

An analysis of risk factors associated with traumatic extremity amputation stump wound infection in a Nigerian setting

Audit of Physicians’ Adherence to the Antibiotic Policy Guidelines in Kuwait

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