A Prospective and Comparative Study between Preoperative Intravenous Prophylactic Antibiotic and Intra-Incisional Prophylactic Antibiotic with Ceftriaxone to Reduce Surgical Site Infection

Abstract

Narayana V, Chandrashekar D*, V Om Pramod Kumar Raja, Koripalli Srija, Megha Kiran GS

Introduction: SSI (Surgical Site Infection) is accounts for 20% of all hospital acquired infections among surgical patients, and are associated with substantial healthcare costs, patient inconvenience and dissatisfaction. Risks factors for SSI are multifactorial which can originate from patient, operative procedure or causative organisms. Initially, the antibiotics were administered post-operatively for treatment of already established SSI. Later the concept of ceftriaxone antibiotic prophylaxis was introduced intraincisional and pre-operative intravenous route. After administration of Intra Venous (IV) antibiotics, it is distribute in systemic pool and into the peripheral pool, which results in low concentration of antibiotic at the site of wound healing. Intra-incisional infiltration of antibiotic, ensures high concentration of antibiotic at the incision site and thus it present in high concentration during the time of healing of the operative wound. Methods: Source of data-All patients undergoing elective and clean abdominal surgeries in the Department of General Surgery at Vydehi Institute of Medical Sciences and Research Centre, Bengaluru during the period of July 2022 to June 2024. Data was collected from the “Case proforma” pertaining to patient’s particulars, history, clinical examination, investigation, diagnosis and surgical procedures. Results: Results of this includes Gender distribution, Surgical site infection, Duration of surgery, Organisms isolated by culture, Clean, clean contaminated and contaminated cases in each group, Categories of SSI in each group, Day of occurrence of SSI in each group, SSI develops among diabetes mellitus patients which were clearly mentioned in results section. Conclusion: This study confirms that the preoperative intra-incisional infiltration of Ceftriaxone has resulted in a significant reduction in SSI rates, which makes a better mode of administration of prophylactic antibiotics.