A comparative study of preoperative intra-incisional infiltration                       of ceftriaxone vs. intravenous ceftriaxone for prevention of surgical site infections

Anoop Singh; Mohammad Salim; Bhal Singh; Akshita .

doi:10.18203/2349-2902.isj20191891

Authors

Anoop Singh Department General Surgery, Sardar Patel Medical, Bikaner, Rajasthan, India
Mohammad Salim Department General Surgery, Sardar Patel Medical, Bikaner, Rajasthan, India
Bhal Singh Department General Surgery, Sardar Patel Medical, Bikaner, Rajasthan, India
Akshita . Department General Surgery, Sardar Patel Medical, Bikaner, Rajasthan, India

DOI:

https://doi.org/10.18203/2349-2902.isj20191891

Keywords:

Surgical site infection, Ceftriaxone, Wound infection

Abstract

Background: Surgical site infection (SSI) continues to be a major causes of post-operative morbidity, mortality since time immemorial. Many methods have been evolved to combat wound infection including concept of antisepsis and use of intravenous antibiotics. But the rate of SSI has been more or less static over the past few decades. The current study was undertaken to check effectiveness of preoperative intra-incisional infiltration of ceftriaxone for prevention of SSI.

Methods: This prospective study included 120 cases. Patients were randomly divided into two equal groups (60 each). Group A, considered control and received single dose of intravenous ceftriaxone (1 gm), whereas Group B, considered test and received intra-incisional ceftriaxone before starting procedure. If any evidence of SSI present, data recorded and swab sample was taken and sent for culture. Result of this analyzed for significance.

Results: In category A, 15 out of 60 patients (25%) developed SSI, while in category B, 3 out of 60 patients (5%) developed SSI. Escherichia coli is the commonest (72.22%) organism responsible for SSI in our study. Mean hospital stay of patients who develop SSI is nearly two times higher than who don’t develop SSI.

Conclusions: This study confirms that the preoperative intra-incisional injection of ceftriaxone has resulted in a significant reduction in SSI infection rates in all classes of wounds both clinically as well as statistically (P value < 0.005).

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References

Bajaj A, Kukanur S, Kotigadde S, Meundi M. Gram Positive Cocci Causing Surgical Site Infection: Identification and Antibiotic Susceptibility Pattern. IOSR J Dental Med Sci. 2015;1(14):62-7.

Gariepy TP. The introduction and acceptance of Listerian antisepsis in the United States. Journal of the history of medicine and allied sciences. 1994;49(2):167-206.

Haley RW, Culver DH, White JW, Morgan WM, Emori TG. The nationwide nosocomial infection rate: a new need for vital statistics. Am J Epidemiol. 1985;121(2):159-67.

Lilani SP, Jangale N, Chowdhary A, Daver GB. Surgical site infection in clean and clean-contaminated cases. Indian journal of medical microbiology. 2005;23(4):249.

Jain A, Bhatawadekar S, Modak M. Bacteriological profile of surgical site infection from a tertiary care hospital, from western India. IJAR. 2014;4(1):397-400.

Westerman EL. Antibiotic prophylaxis in surgery: Historical background, rationa1e, and relationship to prospective payment. American journal of infection control. 1984;12(6):339-43.

Karlatti, Suresh, and I. B. Havannavar. A comparative prospective study of preoperative antibiotic prophylaxis in the prevention of surgical site infections. Int Surg J. 2016;3(1): 141-5.

Armstrong CP, Taylor TV, Reeves DS. Pre‐incisional intraparietal injection of cephamandole: A new approach to wound infection prophylaxis. Br J Surg. 1982;69(8):459-60.

Taylor TV, Walker WS, Mason RC, Richmond J, Lee D. Preoperative intraparietal (intra‐incisional) cefoxitin in abdominal surgery. Br J Surg. 1982;69(8):461-2.

Dogra BB, Kalyan S, Rana KV, Panchabhai S, Kharade K, Priyadarshi S. A study comparing preoperative intra-incisional antibiotic infiltration and prophylactic intravenous antibiotic administration for reducing surgical site infection. Med J DY Patil Univ. 2013;6:405-9.

Patel IH, Kaplan SA. Pharmacokinetic profile of ceftriaxone in man. Am J Med. 1984;77(4C):17-25.

Cleeland R, Squires E. Antimicrobial activity of ceftriaxone: a review. Am J Med. 1984;77(4C):3-11.

Pollock AV, Evans M, Smith GM. Preincisional intraparietal Augmentin in abdominal operations. Annals of the Royal College of Surgeons of England. 1989;71(2):97

Dogra BB, Kalyan S, Rana KV, Panchabhai S, Kharade K, Priyadarshi S. A study comparing preoperative intra-incisional antibiotic infiltration and prophylactic intravenous antibiotic administration for reducing surgical site infection. Medical Journal of Dr. DY Patil University. 2013;6(4):405.

Anand S, Batra R, Arora B, Atwal S, Dahiya RS. A comparative study of preoperative intra-incisional infiltration of ceftriaxone vs. intravenous ceftriaxone for prevention of surgical site infections in emergency cases. J Evolution Med Dent Sci. 2016;5(64):4537-41.

Patil AN, Uppin VM. Intra-incisional versus intravenous route of antibiotic administration in preventing surgical site infections: a randomized controlled trial. International Surgery Journal. 2018;5(4):1438-42

Sudhir S, Telkar KG. A study of the wound performance following subcutaneous infiltration and topical instillation of ceftriaxone before primary closure of skin in laparotomy for peritonitis due to non-traumatic perforation of small intestine. International Surgery Journal. 2017;4(12):3956-61.

Culver DH, Horan TC, Gaynes RP, Martone WJ, Jarvis WR, Emori TG, Banerjee SN, Edwards JR, Tolson JS, Henderson TS, Hughes JM. Surgical wound infection rates by wound class, operative procedure, and patient risk index. The American journal of medicine. 1991;91(3):S152-7.

Kamat US, Fereirra AM, Kulkarni MS, Motghare DD. A prospective study of surgical site infections in a teaching hospital in Goa. Indian Journal of Surgery. 2008;70(3):120.

Mahesh CB, Shivakumar S, Suresh BS, Chidanand SP, Vishwanath Y. A prospective study of surgical site infections in a teaching hospital. J Clin Diagn Res. 2010;4(5):3114-9.