Prophylactic Antibiotics in Vascular Surgery

Abstract

A prospective, randomized, blinded study was performed to determine whether prophylactic antibiotics would reduce the incidence of infection in peripheral vascular surgery and whether the route of antibiotic administration was important. Patients undergoing a vascular procedure with a groin incision were allocated to one of four groups with respect to prophylactic antibiotics. Group I received no antibiotic. Group II had topical cephradine instilled in their incisions prior to closure. Group III received a 24-hour perioperative course of intravenous cephradine, and Group IV received both topical and intravenous cephradine. Groin and abdominal incisional infections were significantly reduced (p < 0.01) among patients who received prophylactic antibiotics by either the topical, systemic, or combined routes of administration. No significant differences were noted among the three antibiotic groups. Profundoplasty, femoral embolectomy, and femoral aneurysm repair were each associated with an increased incidence of infection (p < 0.01). Other risk factors were only important in patients not receiving antibiotics. Either intraoperative topical antibiotics or perioperative systemic antibiotics prevent infection in peripheral vascular surgery, but antibiotic administration by both routes is unnecessary.

Antimicrobial prophylaxis in clean surgery with special focus on inguinal hernia repair with mesh

“…Although antimicrobial prophylaxis was thought to be unnecessary for clean surgery, except when a prosthesis is implanted, several studies support extending the use of antibiotic prophylaxis to other types of clean surgery such as breast operations, 33,37-39 hernia repair, 40 trauma 41 and vascular surgery. 42,43 The use of a single dose of antibiotics may seem harmless, but antibiotics have some risks of an allergic reaction or superinfection, and may contribute to development of bacterial resistance. 44 Between 30% and 50% of the total antibiotic consumption in hospitals is used for prophylactic 45,46 Therefore, unnecessary cost should also be a concern of surgeons.…”

Significant Factors Influencing Wound Infection After Inguinal Hernia Surgery

“…Table 2 while type of surgery and wound infection was shown in Table 3. [30]and vascular surgery, [31,32]but in inguinal hernia repair its benefit remains uncertain. In this study all our patients were given antibiotics but the difference was in type and duration.…”

Role of Negative Pressure Wound Therapy in Treating Peripheral Vascular Graft Infections

“…15,[27][28][29][30][31] Risk factors for groin wound infection include immunosuppression, diabetes mellitus, chronic renal failure, smoking, advanced age, obesity, and emergency surgery. 27,29,32,33 Management often requires prolongation of the hospital stay and multiple operations. 34 Groin wounds complicating a vascular graft infection occur through breaks in sterile technique during the initial procedure, 35 bacterial seeding from hematogenous spread, 36 subsequent degeneration or thrombosis of the graft, or direct contamination of the graft because of the superficial nature of soft tissue groin coverage.…”