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Results for “Prophylactic Surgical Procedures”

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At least 199 records · Page 11Linked to original sources

PubMed2000

A multicenter randomized trial of prophylaxis with intravenous cefepime + metronidazole or ceftriaxone + metronidazole in colorectal surgery. The 230 Study Group.

We compared two prophylactic antimicrobial regimens in 615 patients undergoing elective colorectal surgical procedures. Patients ranged in age from 19 to 92 years (median 66 years); the majority were male (54.0%) and most (77.7%) had neoplastic disease. All underwent mechanical bowel preparation. Patients were randomized to receive preoperative infusions of 2 g cefepime (n=307) or 2 g ceftriaxone (n=308), followed by 500 mg metronidazole. Patients were followed for up to 4 to 6 weeks after surgery. Antimicrobial prophylaxis was successful in preventing primary site infections in 92.8% of patients in the cefepime + metronidazole arm and 92.9% of patients in the ceftriaxone + metronidazole arm. Both regimens were well tolerated. A single dose of cefepime + metronidazole thus seems to be a very useful alternative to other regimens for prophylaxis in patients undergoing colorectal surgery.

Adult↗

PubMed2002

[Antibiotic therapy in surgical intensive care units].

The authors describe contemporary therapeutic procedures of ATB treatment at surgical ICUs. In conjunction with prophylactic administration they describe its indications, selection of ATB and period of administration. They discuss the necessity to start antibiotic treatment which is at first empirical and aimed after the results of cultivation examinations are available.

Antibiotic Prophylaxis↗

PubMed1978

Hematogenous infection of total knee implants.

Three cases of hematogenous infection of total knee replacement are reported. In two cases septicemia following cholecystectomy resulted in E. coli infection of the knee joint. Prophylactic antibiotic therapy of implant patients undergoing dental or surgical procedures is recommended.

Arthroplasty↗

PubMed1998

Removal of asymptomatic third molars: indications, contraindications, risks and benefits.

The removal of third molar teeth is one of the most common surgical procedures performed by dentists in the United States. Although prophylactic removal of third molars is supported by many to prevent disease, the removal of asymptomatic third molars should be based upon individual clinical and radiographic assessment of each patient. After educating the patient as to the indications, contraindications, risks, and benefits of removal of third molars, the patient and dentist should reach a mutual decision as to whether to proceed with surgery.

Contraindications↗

PubMed1982

Complications of abdominal and vaginal hysterectomy among women of reproductive age in the United States. The Collaborative Review of Sterilization.

Although hysterectomy was the most frequently performed major surgical procedure among women of reproductive age during the past decade, few recent studies have been conducted to determine the risk of complications. We examined data from the Collaborative Review of Sterilization, a prospective, multicenter, observational study coordinated by the Centers for Disease Control, to assess the comparative risks of complications among women undergoing hysterectomy by the abdominal and vaginal approaches. Between September, 1978, and August, 1981, 1,851 women from nine institutions were included in the study. Women who underwent vaginal hysterectomy experienced significantly fewer complications than women who had undergone abdominal hysterectomy. The difference was probably attributable to the prevalence and efficacy of prophylactic antibiotic use among the former group. Vaginal hysterectomy was associated with more unintended major surgical procedures but less febrile morbidity, bleeding requiring transfusion, hospitalization, and convalescence than abdominal hysterectomy. Vaginal hysterectomy with prophylactic antibiotics should be strongly considered for those women of reproductive age for whom either surgical approach is clinically appropriate.

Adolescent↗

PubMed2007

Prophylaxis versus pre-emptive treatment for infective and inflammatory complications of surgical third molar removal: a randomized, double-blind, placebo-controlled, clinical trial with sustained release amoxicillin/clavulanic acid (1000/62.5 mg).

The most common complications after surgical extraction of the third mandibular molar are trismus, oedema or swelling, local pain, dysphagia and infection. The aim of this comparative, double-blind, randomized clinical trial was to evaluate the efficacy of two sustained release amoxicillin/clavulanate regimens in the reduction of infection after third molar extractive surgery. A total of 225 patients were randomized into three equal groups: placebo, prophylaxis with single pre-surgical dose of two tablets amoxicillin/clavulanate 1000/62.5 mg, and pre-emptive post-surgery therapy with two tablets amoxicillin/clavulanate 1000/62.5 mg BID for 5 days. A higher rate of infection (P=0.006) was found among patients receiving placebo (16%) than those receiving single-dose prophylaxis (5.3%) or 5-day pre-emptive therapy (2.7%). A relationship between both the duration (13.8% for long versus 7.4% for medium versus 1.6% for short) and difficulty (12.7% with ostectomy versus 3.5% without ostectomy; P=0.011) of surgical procedure and incidence of subsequent infection was also observed. Both prophylactic and therapeutic regimens versus placebo achieved greater reduction of pain after surgery on day 3 (P=0.001). Logistic regression analysis revealed a risk of infection of 24%, 9% and 4% for ostectomy with placebo, prophylaxis and pre-emptive treatment, respectively, whereas it was 7%, 2% and 1% if ostectomy was not performed. Pre-emptive therapy with the oral sustained release amoxicillin/clavulanate formulation reduced the rate of subsequent infection in patients undergoing ostectomy. Prophylaxis was beneficial in simpler procedures and may be indicated in cases where ostectomy is not performed.

Adult↗

PubMed2000

Effectiveness of intestinal tube splinting: a prospective observational study.

BACKGROUND/AIMS: To assess the effectiveness of intestinal tube splinting. PATIENTS AND METHODS: The clinical, operative and outcome data of 186 patients undergoing 200 intestinal splinting procedures from 1973 until 1996 were accumulated in a prospective database. Endpoints were perioperative morbidity, mortality and the incidence of subsequent small bowel obstruction (SBO). The latest follow-up performed in 1998 updated the outcome of 197 procedures after 1-25 (median 7) years. RESULTS: In the early postoperative period, the overall incidence of complications was 9%, procedural complications 2%, and repeat surgery 3%. Three patients died during the index hospitalization. No patient suffered early SBO. Between 1 and 13 years after splinting, 6 complete SBOs (3%) necessitated reoperation and 5 incomplete SBOs (2.5%) were managed conservatively. After splinting for late SBO, freedom from complete SBO was 0.989 and of incomplete SBO 0.906, after splinting for early SBO 0.872 and 0.972, respectively, and for segmental peritonitic SBO freedom from complete SBO 0.8. No obstruction followed prophylactic splinting. CONCLUSIONS: Splinting was a reasonably safe procedure with comparatively low morbidity and mortality. The procedure prevented early SBO in all indicatory subgroups, reduced the rate of late recurrent SBO in patients treated for late adhesive SBO as compared with historical outcome data of simple enterolysis and prevented late SBO when performed prophylactically.

Databases, Factual↗

PubMed2003

Prophylactic oophorectomy: why and when?

Ovarian cancer presents at a late stage and is associated with a very poor chance of cure. Ability to predict women who are at genetic risk has directed our thoughts to the possibility that the timely removal of the ovaries in these women is likely to prevent cancer and save lives. Only approximately 10% of ovarian cancers arise as a result of an inherited condition; it is this group which is most likely to benefit from prophylactic oophorectomy. Women in this group may be identified following referral on the basis of personal or family histories of disease. With continued improvement in genetic screening, the literature regarding prevention of ovarian cancer appears to be moving beyond the appropriateness of prophylactic oophorectomy to a discussion of the technical aspects of the procedure. There is little doubt that this type of surgical prophylaxis will become more popular. Numerous studies have now demonstrated that prophylactic oophorectomy will not only offer a high degree of protection against ovarian cancer but also against breast cancer. It is important for the future that research continues to examine the operative technique and its implications, particularly with regard to Fallopian tube and peritoneal cancer.

Age Distribution↗

PubMed1998

Antimicrobial prophylactic practice in surgical patients.

OBJECTIVE: To evaluate the prescribing patterns of surgeons for pre-operative antimicrobial prophylaxis. DESIGN: A retrospective study based on data obtained from case records of surgical patients admitted into the Department of Surgery. SETTING: Department of Surgery, Royal Commission Medical Center, Madinat Yambu Al-Sinayah. SUBJECTS: The study population comprised of 888 surgical patients who received antibiotic therapy either for prophylaxis or treatment during the period 1st November 1992 and 28th February 1995. RESULTS: A total of 888 surgical patients received antibiotics during the study period, 191 (21.5%) for prophylaxis while 697 (78.5%) were given antibiotics for therapy before and after surgery. Ceftriaxone was the most commonly used antibiotic for prophylaxis, followed by augmentin and cefotaxime, and these were frequently given in multiple doses, extending beyond 24 hours. CONCLUSION: There was unwarranted and over use of prophylactic agents in at least 70% of the patients, with increased costs to the Hospital. Effective prophylaxis can be accomplished with a single dose of a cephalosporin, such as ceftriaxone, cefuroxime or cefazolin, for the common surgical procedures. It is recommended that better compliance with principles of surgical antimicrobial prophylaxis be implemented Prophylactic antibiotic audit measures should be carried out by the control committee. The development of guidelines and standing orders for antimicrobial prophylaxis should help to improve compliance.

Antibiotic Prophylaxis↗

PubMed2005

Postoperative acute confusional state in typical urologic population: incidence, risk factors, and strategies for prevention.

OBJECTIVES: To determine the incidence of, and predictors for, the acute confusional state (ACS) in older patients after urologic surgery. ACS is among the most common complications after surgery in older patients. It is associated with increased postoperative morbidity, longer hospital stays, and greater mortality. Agitation caused by ACS might have deleterious consequences in a large proportion of older patients, especially after urologic surgery. Only a few studies, of highly selected urologic procedures, have been reported, and all showed an astonishingly low percentage of patients with this distressing condition. METHODS: We examined 100 consecutive, older patients (age 60 years or older), prospectively, before and after urologic surgery, to determine both the incidence of, and the predictors for, ACS. RESULTS: Only 7 of the 100 patients developed postoperative ACS. The risk factors identified were preoperative cognitive deficits, pre-existing depression, impaired vision, and the operative time. CONCLUSIONS: These results suggest that postoperative ACS is relatively rare after urologic surgical procedures; however, patients who are likely to develop ACS can be identified, prompting consideration for prophylactic antidelirium care.

Acute Disease↗

PubMed1989

Altered pharmacokinetics of antibiotics during vascular surgery.

Prophylactic antibiotics significantly decrease the incidence of infection in various surgical procedures. Although antibiotics must be administered preoperatively to be effective, it is unknown whether therapeutic concentrations are necessary throughout the operation to prevent infection. Furthermore, the pharmacokinetics of antibiotics during surgical procedures is not well understood. Several factors, including blood loss, fluid redistribution, and changes in renal blood flow may alter the pharmacokinetic disposition of the antibiotic. In a controlled investigation of intraoperative antibiotic pharmacokinetics, cefamandole was studied in eight patients undergoing elective surgery of the abdominal aorta and peripheral vasculature. Both elimination half-life (67 +/- 19 minutes versus 93 +/- 23 minutes) and the volume of distribution (16.8 +/- 5.3 liters versus 25.2 +/- 11.9 liters) increased when compared with the preoperative state. The increased volume may be due, in part, to redistribution of fluid. Plasma concentrations of antibiotic were low at the time of graft placement in those patients with normal renal function. Additional antibiotic dosing may be warranted prior to prosthesis insertion in these patients.

Aorta, Abdominal↗

PubMed1992

Prophylactic use of antimicrobial agents in adult patients.

The prophylactic use of antimicrobial agents is recommended for prevention of numerous infections, including tuberculosis, endocarditis, rheumatic fever, recurrent cellulitis and lymphangitis in patients with lymphedema, meningococcal meningitis, and bite wounds. In addition, the prophylactic use of antimicrobial agents has proved effective in certain surgical procedures such as various abdominal operations, hysterectomy, and major operations that involve the head and neck. Except for oral bowel preparations, antimicrobial prophylaxis should be limited, in general, to the operative period. Prolonged perioperative prophylaxis has not been shown to enhance effectiveness and may result in increased toxicity, resistant superinfections, and inflated costs. The investigation of antimicrobial prophylaxis necessitates adequate evaluation of the potential advantages and disadvantages in a prospective, double-blind fashion.

Adult↗

PubMed1981

Fibrin adhesive and its application in thoracic surgery.

Human fibrinogen cryoprecipitate has found wide application as a biologic tissue adhesive in thoracic and cardiovascular surgery. During 1979 and 1980 fibrin adhesive was applied in all surgical procedures involving persistent or recurrent pneumothorax and it was used prophylactically to cover large parenchymal defects following standard lung resections. The benefit of its application on pleura and lung tissue derives from added reinforcement of sutures and sealing of non-saturable defects. Twenty-one patients with recurrent spontaneous pneumothorax revealed a reduced average drainage period as compared to 15 non-glued cases with lesions of comparable size. Similarly, in 20 cases where tissue adhesive was applied to extensive pleural defects following segmental lung resection or lobectomy, suction drainage time was significantly less than in 11 cases of comparable, non-glued defects. Compared to 140 lung resections performed prior to the use of fibrin glue, these 20 cases were found to require the same average drainage time, although the extent of their lesions would otherwise have warranted longer periods of continued suction drainage.

Adult↗

PubMed1988

Sterile technique and the prevention of wound infection in office surgery--Part I.

Surgical infection and associated complications are minimized by a combination of appropriate sterile technique and careful surgical technique. This review covers the essential elements of infection control for the office-based surgical practice. Recommendations are made concerning operating room facilities, instrument sterilization, and tray setup (Part I). Part II addresses surgical prepping, surgical technique, and prophylactic antibiotics.

Ambulatory Surgical Procedures↗

PubMed1989

Sterile technique and the prevention of wound infection in office surgery--Part II.

Surgical infection and associated complications are minimized by a combination of appropriate sterile technique and careful surgical technique. This review covers the essential elements of infection control for the office-based surgical practice. Recommendations are made concerning operating room facilities, instrument sterilization, and tray set-up (Part I, J Dermatol Surg Oncol 14:1364-1371, 1988). Part II addresses surgical prepping, surgical technique, and prophylactic antibiotics.

Ambulatory Surgical Procedures↗

PubMed1990

Cefmetazole and cefonicid. Comparative efficacy and safety in preventing postoperative infections after vaginal and abdominal hysterectomy.

A single 1-g dose of cefmetazole was compared with a single 1-g dose of cefonicid for prophylaxis in vaginal and abdominal hysterectomy to determine their efficacy and safety. The antibiotics were administered intramuscularly 15-90 minutes before the incision was made. Cefmetazole and cefonicid had similar activity against most of the aerobic organisms recovered, but cefmetazole was significantly more active against anaerobic gram-negative microorganisms. The patterns of regrowth of vaginal flora were similar in the two treatment groups. Patient demographic characteristics and surgical procedures were similar in both groups. The difference in primary prophylactic failure (e.g., cuff cellulitis) with the two study drugs (1 of 53 [1.9%] with cefmetazole and 2 of 28 [7.1%] with cefonicid) did not reach statistical significance, and the results were similar for the two routes of hysterectomy. Cefmetazole, at a dose of 1 g intramuscularly preoperatively, is a safe and effective agent for prophylaxis during hysterectomy.

Adult↗

PubMed1989

Intra-aortic balloon counterpulsation in high-risk cardiac patients undergoing noncardiac surgery.

Patients undergoing noncardiac general surgical procedures after coronary artery bypass surgery have reduced mortality compared with those operated on without prior revascularization. The urgency of the noncardiac procedure and the potential reconstructability of the coronary artery anatomy may mitigate against timely revascularization. We report the successful outcome of prophylactic intra-aortic balloon counterpulsation in three patients with coronary artery disease and impaired left ventricular function undergoing noncardiac surgical procedures. Intra-aortic balloon counterpulsation may provide myocardial protection in high-risk cardiac patients requiring noncardiac surgery initially. A review of the literature is discussed.

Aged↗

PubMed1994

Prophylactic antibiotics and their role in the prevention of surgical wound infection.

Prophylactic antibiotics are indicated in all clean-contaminated and many clean procedures, especially in view of the low complication rates seen with cephalosporin prophylaxis. They are best administered immediately before operation in a manner that insures a tissue level at the time of incision and they should target pathogens commonly associated with the specific operation undertaken. Therapeutic tissue concentrations should be maintained throughout the period of potential bacterial contamination but not beyond 24 hours after surgery. Linton has been proved corrected in predicting the contribution of preventive (prophylactic) antibiotics to surgery. They are a useful tool in the surgeon's effort to minimize the occurrence of postoperative infection. However, these agents must be used with, and cannot replace, meticulous and aseptic surgical technique. Current research providing information concerning the basic cellular and molecular bases of host defense against bacterial primary lodgment and invasion provide strong evidence that the surgical patient of the future will benefit by an extended ability to normalize natural host defenses rendering those few bacteria that gain access to the wound incapable of producing infection. At that time preventive (prophylactic) antibiotics will become less important in the control of postoperative infection.

Anti-Bacterial Agents↗