Prophylactic antibiotics in surgery Flashcards
Why are prophylactic antibiotics used in surgery?
- Reduce risk of surgical wound infection
What measures can be taken to reduce risk of wound infection?
- Time antiobiotic administration correctly
- IV prophylaxis 30 min prior to maximize skin concentration
- Metronidazole PR is given 2 hours before
- Antibiotics should work against anaerobes and coliforms
- Peri-operative supplement oxygen can reduce wound infection incidence
- Practice strictly sterile surgical techniques
What is the peri-operative antibiotic regimen to reduce wound infection risk in Appendicetomy, coloerctal resections and open biliary surgery?
- Single dose of IV piperacillin or gentamicin
- metronidazole or co-amoxiclav
What is the peri-operative antibiotic regimen to reduce wound infection risk in oesophageal or gastric?
- IV piperacillin or gentamicin
- metrondazole or co-amoxiclav
What is the peri-operative antibiotic regimen to reduce wound infection risk in vascular surgery?
- IV piperacillin or flucloxacillin
- gentamicin
- Add metronidazole if risk of anaerobes (amputations, gangrene, diabetes)
What antibiotics can be added if a person with MRSA is going for surgery?
- Vancomycin
- or Teicoplanin
What is meant by a clean surgical site and what is the infection risk?
- Incising uninfected skin without opening a viscus
- <2% infection risk
What is meant by a clean-contaminated surgical site and what is the infection risk?
- Intra-operative breach of a viscus (not colon)
- 8-10% infection risk
What is meant by a contaminated surgical site and what is the infection risk?
- Breach of a viscus + spillage or opening of colon
- 12-20% infection risk
What is meant by a dirty surgical site and what is the infection risk?
- Site is already contamined with pus or faeces, or from exogenous contagion
- 25% infection risk
Teach me surgery guidelines to prophylactic antibiotic therapies for specific procedures
