ABSTRACT
In a private 160-bed orthopedic hospital, the effect of air decontamination and antibiotic prophylaxis on postoperative infections was studied. From 1971 to 1978, 5 016 orthopedic procedures were performed without antibiotic prophylaxis. Postoperative infection rate was 2% with the conventional operating room and 1.9% with the sterile room. The beneficial effect of vertical laminar air flow thus appears doubtful. From 1979 to 1982, prophylactic therapy with a cephalosporin was used for total hip replacements. Rate of postoperative deep infection fell from 3.3% in 811 hip replacements without antibiotics to 0.5% in 1 172 replacements with antibiotic prophylaxis. Our findings suggest that cephalosporin prophylaxis is more effective than vertical laminar air flow for preventing postoperative hospital-acquired infection.
Subject(s)
Air Microbiology , Bacterial Infections/prevention & control , Cephalosporins/therapeutic use , Decontamination , Hip Prosthesis/adverse effects , Premedication , Bacterial Infections/etiology , Humans , Postoperative Complications/prevention & controlABSTRACT
In a previous paper the authors studied the role of aerobio-contamination in the rate of post-operative infections. In the present study, the results of 1,172 total hip prostheses performed between 1979/1982 with prophylactic antibiotics were compared with those obtained in 811 cases performed before 1979 without antibiotics. In the 1979/1982 series, there was 0,5 p. 100 of post-operative infection and in the pre- 1979 series, 3,3 p. 100. During the two periods the peri-operative environment was identical and the surgical technique was the same. The rate of infection in more than 8,000 other surgical procedures performed in the same hospital remained the same. The use of prophylactic antibiotics appears to be a valid approach. They should be used only in high-risk procedures to avoid the selective production of resistant organisms.
