Prophylactic antibiotics in soft-tissue procedures in children with cerebral palsy

Abstract

PurposeData on the benefits of perioperative prophylactic antibiotics in the paediatric population are lacking. In this study, we aimed to assess the rate of infection after isolated soft-tissue procedures in patients with cerebral palsy with and without preoperative prophylactic antibiotics between 2009 and 2015.MethodsWe reviewed the records of all children with cerebral palsy who underwent isolated soft-tissue procedures (on the upper and lower limb) at our hospital between 2009 and 2015. Children with at least 30-day postoperative follow-up were included. Children who had groin incisions were excluded.ResultsTwo groups were identified: the antibiotic group (77 children with 203 incisions and 343 procedures) had one surgical site infection; the no-antibiotic group (48 children with 102 incisions and 177 procedures) had no surgical site infections.ConclusionThese results suggest that the use of preoperative antibiotics does not change the rate of postoperative surgical site infections.Level of EvidenceLevel III therapeutic study

Profilaxis antibiótica en cirugía ortopédica pediátrica aplicando las Guías de la Sociedad Americana de Farmacéuticos del Sistema de Salud

“…Hay pocos estudios que hablan sobre la profilaxis antibiótica limitada en pacientes de edad pediátrica, Perotii en 2018 publicó un estudio de 125 pacientes con parálisis cerebral infantil que fueron sometidos a procedimientos quirúrgicos sin implante, en extremidades superiores e inferiores, a 77 pacientes se les administró antibiótico durante el prequirúrgico y uno de estos presentó infección de sitio quirúrgico, al contrario de su segundo grupo de estudio, donde a 48 pacientes no se les administró profilaxis antibiótica y no se presentó infección del sitio quirúrgico, demostrando así que el uso de una profilaxis antibiótica limitada no aumenta el riesgo de presentar una infección del sitio quirúrgico. 11 Formaini realizó un estudio retrospectivo en el cual analizó a un total de 2,330 pacientes, quienes fueron sometidos a procedimientos quirúrgicos mínimamente invasivos y ambulatorios, a 1,087 pacientes se les administró profilaxis antimicrobiana, y al resto, correspondiente a 1,243 pacientes, no se les administró antibiótico previo ni posterior al evento quirúrgico. Resultando que únicamente uno de los 2,330 pacientes presentó una infección del sitio quirúrgico en los primeros 30 días postquirúrgicos, perteneciente al grupo al que no se le administró antibioticoterapia.…”

Variation Among Surgeons Regarding the Use of Preoperative Antibiotics in Percutaneous Pinning Procedures of the Upper Extremity in the Pediatric Population

“…[13][14][15] A study of infection rates associated with soft-tissue procedures in children with cerebral palsy found no significant difference between cohorts receiving prophylactic antibiotics and those who did not. 16 The efficacy of preoperative antibiotics in minimally invasive orthopedic procedures such as carpal tunnel and trigger finger releases in adults has been explored in detail in recent years. A 2010 study by Harness et al 17 reported lack of statistical significance in infection rates between cohorts with and without the use of prophylactic antibiotics in carpal tunnel release procedures.…”