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1.
Egyptian Journal of Hospital Medicine [The]. 2018; 70 (5): 777-785
em Inglês | IMEMR | ID: emr-192593

RESUMO

Background: prophylactic antibiotics are effective in preventing surgical-wound infections. However, the clarity about the compelling need for antibiotic administration and the risk associated with their use is missing. The use of antimicrobial prophylaxis against surgical site infection [SSI] is common in plastic surgery, while results from prospective randomized controlled trials are scarce


Aim of the Study: was to evaluate the need for antibiotic prophylaxis in the field of plastic surgery


Methods: Electronic search of available Literatures in the scientific database of recent randomized controlled trials evaluating the indications for and use of antibiotics to reduce and treat SSIs for patients undergoing plastic surgery from 1960 to 2017- [Medline, Embase, the Cochrane Library as well as NHS centre websites were searched for English Publications from both reprint requests and by searching the database. Data extracted included antibiotic dosage, duration and incidence of surgical site infection


Conclusion: surgical procedures must be distinguished based on the risk of infection and the need for antibiotic prophylaxis should be determined accordingly, i.e. on a case by case basis.No prophylaxis is required for superficial skin's and clean surgeries such as mucosal excisions, nevertheless, Antibiotic prophylaxis is recommended microsurgical operations, prosthetic surgery, incisional hernias, clean non-prosthetic osteoarticular surgery, oral cavity and genitourinary system procedures. Still, antibiotic use should be prescribed with caution to avoid profound side effects such as developing resistant bacterial strains, severe allergies and other accompanied comorbidities

2.
Egyptian Journal of Hospital Medicine [The]. 2018; 70 (9): 1568-1571
em Inglês | IMEMR | ID: emr-192693

RESUMO

Background: Surgeons are regularly not involved in the post discharge care of patients after uncomplicated laparoscopic cholecystectomy. The purpose of the current study was to document the symptomatic recovery of patients following laparoscopic cholecystectomy, because this has a bearing on the planning of a postoperative care package


Methods: The study was designed as a postoperative telephone questionnaire survey and was carried out prospectively between June2016 and February2017 in King Abdulaziz Hospital, KSA


Results: The study cohort comprised 51 patients who all completed the study. Postoperatively, only 3% of the patients had postoperative nausea/vomiting lasting >/=2 days. Pain was symptomatic in 12% of patients. Port-site wounds were a source of significant symptoms in 69% of the patients. Postoperative reviews by a nurse and primary-care doctor were necessary in 76% and 34% patients, respectively, with a combined average of 3.1 reviews per patient. Less than 4% of patients believed that they would benefit from a surgeon's review 6 weeks after LC. Median time taken to return to routine preoperative activity after surgery was 21 days [IQR, 16 to 33], which was affected by the degree of activity undertaken, wound-related symptoms persisting for >/=3 weeks, planned follow-up clinic appointment, and discharge as an outpatient


Conclusion: Wound-related symptoms are common after LC, require substantial input from the community health service in their management, and may delay return to preoperative routine

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