Short term metronidazole therapy contrasted with povidone-iodine spray in the prevention of wound infection after appendicectomy

Salem, R. J.; Johnson, Jay; Devitt, Peter G.

doi:10.1002/bjs.1800660618

Cited by 38 publications

(11 citation statements)

References 4 publications

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“…However, 57% of wound infections did not become apparent until after the patient had gone home, a finding previously noted by Salem, Johnson and Devitt (1979) and by Bates et al (1980). It is therefore important that any study of postoperative wound infection should include adequate follow-up but such late infections are usually relatively minor and seldom require re-admission to hospital.…”

Section: Discussionsupporting

confidence: 51%

Metronidazole v. cefoxitin in severe appendicitis—a trial to compare a single intraoperative dose of two antibiotics given intravenously

Corder¹,

Bates²,

Prior³

et al. 1983

Postgraduate Medical Journal

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SummaryIn severe appendicitis, the effect of a single intravenous dose of metronidazole (500 mg) was compared with cefoxitin (1 g). The antibiotics were given by random allocation once the diagnosis had been established at operation.In the metronidazole group, 5 out of 48 patients developed a wound infection whilst in hospital compared with 13 out of 48 in the cefoxitin group (P=0-036). However, 57% of wound infections became apparent after the patient went home and the overall infection rates were similar.The mean length of postoperative hospital stay was 5-0 days in the metronidazole group and 6-8 days in the cefoxitin group (P= 0052), but of those who did develop a wound infection, the length of stay was almost double in the cefoxitin group. Anaerobic organisms were cultured from the wound in 7 out of 15 patients who received cefoxitin but in none of 5 patients in the metronidazole group. Whilst metronidazole only delayed the discharge of pus from the wound, it did seem to reduce the severity of infection. Cefoxitin appeared to be less effective, given as a single intravenous injection at a dose of 1 g.

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Section: Discussionsupporting

confidence: 51%

Metronidazole v. cefoxitin in severe appendicitis—a trial to compare a single intraoperative dose of two antibiotics given intravenously

Corder¹,

Bates²,

Prior³

et al. 1983

Postgraduate Medical Journal

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show abstract

“…Our data suggest that SSI rates are not generally correlated with postdischarge surveillance intensity, as measured by the percentage of SSIs detected after discharge among patients who are not readmitted to the hospital. Previous studies have shown that 12%-84% of SSIs are detected after patients are discharged from the hospital [16,[23][24][25][26][27][28][29][30][31][32][33][34][35][36][37][38][39][40][41]. Postdischarge surveillance methods have been used with varying degrees of success for different procedures and among hospitals, and they include direct examination of patients' wounds during followup visits to either surgery clinics or physicians' offices [8,18,23,16,30,37,[42][43][44], review of medical records of surgery clinic patients [29,42,45], administration of questionnaires to patients by mail or telephone [8,25,27,28,31,32,38,[46][47][48], or administration of questionnaires to surgeons by mail or telephone [8, 16, 24, 27-29, 33, 34, 36, 38, 45].…”

Section: Discussionmentioning

confidence: 99%

Surgical Site Infection (SSI) Rates in the United States, 1992–1998: The National Nosocomial Infections Surveillance System Basic SSI Risk Index

Gaynes¹,

Culver²,

Horan³

et al. 2001

CLIN INFECT DIS

469

281

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By use of the National Nosocomial Infections Surveillance (NNIS) System's surgical patient surveillance component protocol, the NNIS basic risk index was examined to predict the risk of a surgical site infection (SSI). The NNIS basic SSI risk index is composed of the following criteria: American Society of Anesthesiologists score of 3, 4, or 5; wound class; and duration of surgery. The effect when a laparoscope was used was also determined. Overall, for 34 of the 44 NNIS procedure categories, SSI rates increased significantly (P< .05) with the number of risk factors present. With regard to cholecystectomy and colon surgery, the SSI rate was significantly lower when the procedure was done laparoscopically within each risk index category. With regard to appendectomy and gastric surgery, use of a laparoscope affected SSI rates only when no other risk factors were present. The NNIS basic SSI index is useful for risk adjustment for a wide variety of procedures. For 4 operations, the use of a laparoscope lowered SSI risk, requiring modification of the NNIS basic SSI risk index.

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“…Although a significant reduction in wound infection has been shown by some workers (1 -3), others have failed to demonstrate this (4,5). The results have also been variable when povidone iodine was compared with antibiotic prophylaxis (3,(5)(6)(7)(8). These inconsistencies may be explained, at least in part, by variations in the groups of patients studied and in surgical technique, as the overall levels of wound sepsis in these studies vary widely.…”

Section: Lower Level Of I 1 Per Cent (Pmentioning

confidence: 99%

The effect of topical povidone iodine on wound infection following abdominal surgery

Gray

Lee

1981

Journal of British Surgery

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The effect of povidone iodine on wound sepsis following gastrointestinal surgery was studied in a trial involving 153 patients of whom 72 had their wounds sprayed with povidone iodine dry powder (Disadine DP) and 81 acted as a control group. The infection rate of 9.9 per cent in the patients treated with povidone iodine was significantly lower than that of 24.4 per cent in the control group (P less than 0.05). Bacterial contamination of the wound at the time of operation was shown to be of importance, being associated with a 52 per cent infection rate in the control group. However, spraying of contaminated wounds with povidone iodine reduced the infection rate to the significantly lower level of 11 per cent (P less than 0.05). We conclude that povidone iodine is a safe and effective means of reducing wound sepsis following gastrointestinal surgery.

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Short term metronidazole therapy contrasted with povidone-iodine spray in the prevention of wound infection after appendicectomy

Cited by 38 publications

References 4 publications

Metronidazole v. cefoxitin in severe appendicitis—a trial to compare a single intraoperative dose of two antibiotics given intravenously

Metronidazole v. cefoxitin in severe appendicitis—a trial to compare a single intraoperative dose of two antibiotics given intravenously

Surgical Site Infection (SSI) Rates in the United States, 1992–1998: The National Nosocomial Infections Surveillance System Basic SSI Risk Index

The effect of topical povidone iodine on wound infection following abdominal surgery

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