SMJ // October 1977, Volume 70 - Issue 10
Article
Infection Surveillance Identifying the Problems and the High‐Risk Patient
ABSTRACTA prospective wound surveillance program (47,917 wounds studied) proved valuable in determining the factors responsible for infection, the operations at risk, and the influence of variables. Because the rate of infection in clean wounds is the most sensitive indicator of surgical technic, it is a useful method of quality control.
Article
Microbiologic Basis for the Rational Use of Prophylactic Antibiotics
ABSTRACTAppropriate use of antibiotics is enhanced by the effective application of data on antimicrobial susceptibility. A number of methods are currently available for routine determination of susceptibilities, including agar dilution, broth dilution, agar diffusion, and several semiautomated methods. If susceptibility testing is properly done, it can serve as the basis…
Article
Biliary Tract Surgery
ABSTRACTPostoperative wound infection rates after biliary tract surgery vary tremendously from 2% after uncomplicated cholecystectomy to 20% in series including many jaundiced patients. Almost all such infections arise from organisms growing in the diseased biliary tract, since infection rates of 1% are achieved when the bile is sterile. A history…
Article
Gastric Surgery
ABSTRACTIn a prospective, double-blind, randomized study of patients subjected to gastric surgery, parenteral cefazolin begun before operation significantly reduced the wound infection rate. Infection developed only when incisional contamination occurred during operation and either when the antibiotic was not present in the tissues of the wound at the time of…
Article
Abdominal Hysterectomy
Article
Vaginal Hysterectomy
ABSTRACTThe role of antibiotic prophylaxis in women undergoing vaginal hysterectomy is reviewed. Although there has been a wide range in the reported incidence of postoperative infection and a wide variation in the definition of infectious morbidity, all of the reported studies to date have shown a decrease in the number…
Article
Role of Preventive Antibiotics in Patients Undergoing Cesarean Section
ABSTRACTEighty patients in labor and requiring cesarean section were selected randomly for a double-blind study using prophylactic cephalosporin and placebo. There were 26 treated patients who had no morbidity versus 13 in the control group. The reduction in endometritis was significant (P = <.05). The most prevalent organism was Streptococcus…
Article
Antibiotic and Bacteriologic Considerations in Open Fractures
ABSTRACTA prospective study involving 581 open fracture wounds was conducted to evaluate the antibiotic and bacteriologic considerations in the treatment of open fractures. Multiple cultures were taken of each wound, and each wound had formal surgical irrigation and debridement. An organism was present in at least one of the multiple…
Article
Orthopedic Surgery
Article
Prophylactic Antibiotics in Elective Orthopedic Surgery A Prospective Study of 1,591 Cases
ABSTRACTA double-blind prospective study involving 1,591 clean orthopedic surgical procedures was done to test the effectiveness of preoperative and intraoperative antibiotics in reducing the postoperative infection rate. The antibiotic and placebo groups were analyzed carefully for factors known to predispose to infection. Several minor exceptions were noted, but generally the…
Article
Joint Replacement
ABSTRACTJoint replacement at the Hospital for Special Surgery has shown that the procedure of cementing total hip replacement components in place carries a high risk of infection. Simple preventive measures against infection are essential, including careful identification of patients at special risk, preoperative eradication of all possible foci of infection,…
Article
Open‐Heart Surgery
ABSTRACTA randomized prospective study of the relative effectiveness of broad-spectrum versus specific antistaphy-lococca!; antibiotic prophylaxis in open-heart surgery was done between May 1972 and June 1973. All patients undergoing open-heart surgery were assigned randomly (by hospital number) to receive either methicillin (M) or cephalo-thin (C) beginning the night before operation….
Article
Pulmonary Resection
ABSTRACTSeventy-seven patients who had elective pulmonary resections were enrolled in a prospective double-blind study to assess the role of prophylactic antibiotics in preventing postoperative infections. Criteria for infection were strictly defined. A five-day course of a cephalosporin (2 gm/ day in divided doses) was compared to an identical placebo. There…
Article
Perioperative Antibiotic Prophylaxis Against Vascular Graft Infection
ABSTRACT:This study investigated the efficacy of perioperative antibiotics in preventing bacteremic infection of vascular suture lines, Dacron grafts, and bovine heterografts. One hundred forty-nine dogs had either segmental excision of the abdominal aorta with primary repair, Dacron prosthesis, or bovine heterograft placement. Animals were randomly assigned to a control group,…
