“May all be happy, may all be healed, may all be at peace and may no one ever suffer."
Surgical prophylaxis refers to the administration of antibiotics before surgery to prevent surgical site infections (SSIs). SSIs are infections that occur in the body’s tissues, organs, or spaces created by surgery. They are the most common healthcare-associated infections (HAIs) and are associated with increased morbidity, mortality, length of hospital stay, and healthcare costs.
The aim of surgical prophylaxis is to reduce the risk of SSIs by administering the appropriate antibiotic(s) at the right dose and time, according to established guidelines. The selection of antibiotics depends on various factors, including the type of surgery, patient’s age and medical history, and local resistance patterns.
The timing of antibiotic administration is critical for the success of surgical prophylaxis. Antibiotics should be given within one hour before surgical incision, or within two hours for vancomycin or fluoroquinolones. This is because the highest risk of contamination occurs during the first hour after incision.
The duration of prophylaxis also varies depending on the surgery. For most procedures, a single dose of antibiotic is sufficient, while for some surgeries, such as cardiac surgery or prosthetic joint replacement, a longer course of antibiotics may be required.
Apart from antibiotic prophylaxis, other measures to prevent SSIs include appropriate skin preparation, maintaining normothermia, minimizing tissue trauma, optimizing blood glucose control, and avoiding shaving.
In conclusion, surgical prophylaxis is a key component of infection control in the surgical setting. It has been shown to significantly reduce the incidence of SSIs and improve patient outcomes. The appropriate selection, timing, and duration of antibiotic prophylaxis, as well as the implementation of other preventive measures, can help minimize the risk of SSIs and improve patient safety.