Publication:

A comparative study of surgical site infections in clean elective surgical procedures with and without antibiotic prophylaxis

Background Surgical site infections (SSI) are the primary (40%) cause of nosocomial infection in surgical patients. Surgical antibiotic prophylaxis (SAP) is the use of antibiotics to prevent infections at the surgical site. However, in clean surgical wound inappropriate antibiotic prophylaxis such as inappropriate selection, timing and duration are associated with an increase in the prevalence of antibiotic resistance, cause adverse drug reaction, cost burden for treatment and increased risk of surgical site infections. Objective of this study is to evaluate the judicious omission of antibiotic in clean elective cases.

Methods This observational case-control study carried out at Command Hospital, Western Command Chandimandir Haryana India, compared surgical site infection (SSI) rates in 224 patients undergoing elective clean surgical procedures, with 112 receiving antibiotic prophylaxis (control group) and 112 not receiving antibiotics (case group).

Results The study found increased induration on postoperative day 3 in patients not receiving antibiotics had a higher incidence of induration (29.5% vs 12.5%) however no significant difference in major grade SSI (as per Southampton Wound Grading System)  rates and  SSI rates were comparable between groups on postoperative days 7, 14 and 30.

Conclusions The study suggests that antibiotic prophylaxis may reduce early postoperative induration, but its effectiveness in preventing long-term SSIs is uncertain. Further research is needed to confirm the results and establish clear guidelines for antibiotic prophylaxis in elective clean surgical procedures. The study highlights the importance of judicious antibiotic use.