Single versus 3-dose antibiotic prophylaxis in clean and clean contaminated operations

Infection is a great problem in surgery and is encountered by all surgeons by nature of their craft; they invariably impair the first line of host defence. Bacteria may enter the wound during or after the operation and may be of endogenous or exogenous origin. The objective of this study was to determine the effectiveness of preoperative antibiotic prophylaxis in reduction of postoperative wound infection in clean and clean contaminated procedures and to compare the cost of antibiotic prophylaxis in both groups. This was a prospective study done on patients in General Surgery Department, Al-Noor Specialist Hospital, Holly Makkah, Saudi Arabia from 1[st] April 2006 to 30[th] March 2007. Total 400 patients were divided into 2 groups of 200 patients each: Group-A received single dose antibiotic prophylaxis, and Group-B received 3 doses of antibiotic therapy. Only clean and clean contaminated procedures were included and results were compared. In Group A, clean procedures [Group-A1] were 110, and clean contaminated [Group-A2] were 90 patients. In clean procedure, rate of infection was 5 out of 110 [4.54%] and in clean contaminated procedures it was 3 out of 90 [3.33%]. In Group B, in clean procedures [Group-B1], rate of infection was 7 out of 90 [7.77%], while in clean contaminated procedures [Group-B2] it was 9 out of 110 [8.18%] patients. Over all wound infection rate after single dose antibiotic prophylaxis was 4% in both procedures and 8% after 3-dose antibiotic therapy. Single dose antibiotic prophylaxis is as effective as 3-dose therapy in clean and clean contaminated procedures to prevent wound infection and is cost-effective

Comparison of etiology and rate of infection in different surgical wounds

To recommend the steps to decrease the wound infection and improve the health care facilities by comparing the incidence of infection in different surgical wounds and to see the causes of these infections. Cross-sectional, comparative prospective study. Al-Noor Specialist Hospital, Holly Makkah, KSA. 1-06-2005 to 30-5-2006. This is a prospective study, which includes 520 patients above the age of 12 years including both males and females. All the patients under went surgery either elective or emergency. Patients were divided in to 04 groups according to the standard surgical wound classification. All the 520 patients were admitted in general surgery department of Al-Noor specialist Hospital, Makkah, KSA. Out of these 340 patients [65.38%] underwent emergency surgery and 180 patients [34.6%] underwent elective surgery. These patients were divided in to four groups according to the standard wound classifications i.e. clean, clean contaminated, contaminated and dirty wounds. In elective surgery, we can avoid the 'wound infection by stopping smoking at least 2 weeks before surgery, good control of diabetes mellitus, lung and cardiovascular disease before surgery, antibiotic prophylaxis on induction o anesthesia and avoid excessive blood loss during surgery. In emergency surgery, we can avoid wound infection by making the arrangement that patients can reach the hospital in early course. of their disease, early diagnosis, good antibiotic cover, less operative time, experienced surgeon and peroperatively good peritoneal lavage