A comparative study between preoperative intraincisional coamoxiclav infiltration and intravenous coamoxiclav injection for prevention of surgical site infection

Vishal Kumar Neniwal; Pooja Chohan; Nitin Neniwal; Rakesh Kumar Sharma; Ramgopal Meena

doi:10.18203/2349-2902.isj20252277

Authors

Vishal Kumar Neniwal 1Department of Urology, Jhalawar Medical College, Jhalawar Rajasthan, India https://orcid.org/0000-0001-7876-6792
Pooja Chohan Department of Paediatrics, S. B. Govt Hospital Sujangarh, Churu, Rajasthan, India
Nitin Neniwal Department of Pharmacology, J. L. N Medical College, Ajmer, Rajasthan, India
Rakesh Kumar Sharma Department of General Surgery, Govt Medical College, Kota, Rajasthan, India
Ramgopal Meena Department of General Surgery, Govt Medical College, Kota, Rajasthan, India

DOI:

https://doi.org/10.18203/2349-2902.isj20252277

Keywords:

Antibiotic prophylaxis, Wound infection, Preoperative, Coamoxiclav, Surgical site infection

Abstract

Introduction: Infection remained a great problem in surgical practice. Infection is encountered by all surgeons by the nature of their craft; they invariably impair the first line of host defense. It happens to be one of the major causes of post-operative morbidity and mortality. Intraincisional antibiotic injection should be beneficial in two ways; very high wound levels will prevent wound sepsis, and good serum levels will minimize systemic complications.

Methods: This is a prospective randomized controlled study comprising of 200 patients divided in to two groups i.e. 100 in each group. Group A-Preoperative intraincisional infiltration of 1.2g Coamoxiclav dissolved in 20 ml of 0.9% saline solution will be infiltrated along the skin and the subcutaneous tissue in the proposed line of incision, 20 minutes before surgical incision. Group B-Preoperative administered a single dose of 1.2 g Coamoxiclav intravenously just before the induction of anaesthesia.

Result: Overall incidence of SSI in Group A was 1% and in Group B 6%. Overall average time for complete healing in group A less than group B. Frequency of infection due to gram negative bacteria was more as compared to gram negative in the cases that developed SSI.

Conclusion: The incidence of SSI was lower in the group of patients who were subjected to preoperative intraincisional Coamoxiclav infiltration as compared to the group who received preoperative intravenous Coamoxiclav. There was statistically significant relation between the types of wounds, duration of surgery to the development of SSI in this study.

Metrics

Metrics Loading ...

References

Emori TG, Edwards JR, Culver DH, Sartor C, Stroud LA, Gaunt EE, et al. Accuracy of reporting nosocomial infections in intensive-care–unit patients to the National Nosocomial Infections Surveillance System: a pilot study. Infection Control Hospital Epidemiol. 1998;19(5):308-16. DOI: https://doi.org/10.1086/647820

Taylor TV, Walker WS, Mason RC, Richmond J, Lee D. Pre operative intraincisional Cefoxitin in abdominal surgery. Br J Surg. 1982;69:461-2. DOI: https://doi.org/10.1002/bjs.1800690809

Dongra BB. A comparing pre operative intraincisional cefotaxime infiltration and compare with prophylactic intravenous infect control. Ann R Coll Surg Eng. 2003;10:18290

Pollock AV, Evans M, Smith GM. Preincisional intraparietal Coamoxiclav in abdominal operations. Ann R Coll Surg Eng. 1989;71:97-100.

Armstrong CP, Taylor TV, Reeves DS. Preincisional intraparietal injection of cefamandole: A new approach to wound infection prophylaxis. Brit J Surg. 1982;69:459-6. DOI: https://doi.org/10.1002/bjs.1800690808

Bhaskar S, Sarda A, Bhalla SA, Goyal A, Gautam G, Pandey D. Pre-operative intra incisional antibiotic infiltration for prevention of surgical site infection. Indian J Clin Pract. 2004;15:57-61. DOI: https://doi.org/10.1016/j.jhin.2004.01.028

Kamat US, Fereiira AMA, Kulkarni MS, et al. A prospective study of surgical site infections in a teaching hospital in Goa. Indian J Surg. 2008;70(3):120-4. DOI: https://doi.org/10.1007/s12262-008-0031-y

Khan SA, Rao PGM, Rao A. Survey and evaluation of antibiotic prophylaxis usage in surgery wards of tertiary level institution before and after the implementation of clinical guidelines. Indian J Surg. 2006;68(3):150-6.

Akalin HE, Surgical prophylaxis: the evolution of guidelines in an era of cost containment. J Hyosp Infect. 2002; 50(1):63-77. DOI: https://doi.org/10.1053/jhin.2001.1121

Barnard HR, Cole WR. The prophylaxis of surgical infection: effect of prophylactic antibiotic drugs on the incidence of infection following potentially contaminated operations. Surgery. 1964;56:151-7

Howard JM, Barker W, Culbertson W, Grotzinger PJ, Iovine VM, Keehn RJ, et al. Postoperative wound infections: the influence of ultraviolet irradiation of the operative room and of various other factors. Ann Surg. 1964;160(2):1-196.

Saito A, Leigh DA, Robinson DP. The pharmacokinetics of BRL 25000-Augmentin in humans. InProceedings of an International Symposium on Augmentin (BRL 25000), Montreux, Switzerland. 1981;17:34-46.