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Wound Infection

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28061. The place of antibiotics in preventing wound infection after clean operations in an Indian hospital: a prospective, randomised, controlled clinical trial. Full Text available with Trip Pro

The place of antibiotics in preventing wound infection after clean operations in an Indian hospital: a prospective, randomised, controlled clinical trial. Two hundred patients in a major Indian hospital who were undergoing clean operations participated in a prospective, randomised, controlled clinical trial of the effectiveness of systemic antibiotics in preventing wound infectious. Of the patients on antibiotics 12.6% developed wound infections and of those not on antibiotics 13.3% did (...) --a difference of no significance. Other factors analysed which included age, duration of operation, place on the operating list and length of the incision did not appear to effect the incidence of infection. Wound infection delayed the discharge of the patient from hospital by seven days. Avoiding antibiotic prophylaxis in these operations would have saved our hospital 12,500 pounds a year. We suggest that prophylactic antibiotics are ineffective in preventing wound infection after clean operations in India

1983 Annals of the Royal College of Surgeons of England Controlled trial quality: uncertain

28062. A comparison of cefotetan and cephazolin for prophylaxis against wound infection after elective cholecystectomy. (Abstract)

A comparison of cefotetan and cephazolin for prophylaxis against wound infection after elective cholecystectomy. In a prospective randomized study 168 patients received a single dose of either cephazolin or cefotetan (1 g) as a prophylactic against wound infection after cholecystectomy. In the cephazolin group 10.3% and the cefotetan group 14.4% developed wound infections (Chi-squared = 0.34 P = less than 0.6 greater than 0.5).

1985 The Journal of hospital infection Controlled trial quality: uncertain

28063. The value of adjuvant systemic antibiotic therapy in localised wound infections among hospital patients: a comparative study. (Abstract)

The value of adjuvant systemic antibiotic therapy in localised wound infections among hospital patients: a comparative study. In a prospective randomised double-blind controlled trial that involved 73 patients with non-invasive wound infections receiving local wound treatment, the effect of adjuvant systemic antibiotic therapy was compared with that of a placebo. On inspection, more wounds were assessed as clinically clean after administration of an antibiotic than after the placebo was given (...) antibiotic therapy in the management of infected wounds promotes bacterial clearance and this may enhance healing of wounds.

1986 The Journal of infection Controlled trial quality: uncertain

28064. Metronidazole prophylaxis in acute mural appendicitis: failure of a single intra-operative infusion to reduce wound infection. (Abstract)

Metronidazole prophylaxis in acute mural appendicitis: failure of a single intra-operative infusion to reduce wound infection. The efficacy of a single 500 mg intravenous intra-operative dose of metronidazole in the prevention of postoperative wound infection, following appendicectomy for acute mural appendicitis, was studied in a prospective randomized placebo controlled trial. Fourteen of the 96 patients (14.6%) in the metronidazole group and 13 of the 94 in the placebo group (13.8 (...) %) developed postoperative wound infection. Late sepsis was noted in 4 out of the 96 patients in the metronidazole group and in one of the 94 patients in the placebo group. This study suggests that a single intra-operative dose of metronidazole dose not reduce the incidence of postoperative wound infection following appendicectomy for acute mural appendicitis.

1987 The Journal of hospital infection Controlled trial quality: uncertain

28065. Perioperative prophylaxis with sulbactam and ampicillin compared with metronidazole and cefotaxime in the prevention of wound infection in children undergoing appendectomy. (Abstract)

Perioperative prophylaxis with sulbactam and ampicillin compared with metronidazole and cefotaxime in the prevention of wound infection in children undergoing appendectomy. Sulbactam is a beta-lactamase inhibitor, which when administered with ampicillin, increases the latter agents antibacterial activity against beta-lactamase producing organisms. One hundred children between the ages of 5 and 14 undergoing emergency appendectomy were entered into a prospective randomized trial comparing (...) sulbactam and ampicillin (SA) with metronidazole and cefotaxime (MC) as prophylaxis against postoperative wound infection. Patients in whom the appendix was perforated or gangrenous received a 72-hour course of antibiotics, others received a single dose only. The overall wound infection rate was 8% (14% in patients with perforation or gangrene and 4% in those without). There was no difference in infection rate between the two antibiotic groups; there were three wound infections and one subphrenic

1987 Journal of pediatric surgery Controlled trial quality: uncertain

28066. Peri-incisional mezlocillin versus rectal-metronidazole for wound infection prophylaxis. (Abstract)

Peri-incisional mezlocillin versus rectal-metronidazole for wound infection prophylaxis. One hundred and forty patients who underwent appendicectomy were included in a prospective randomized trial to compare the ability of preoperative rectal metronidazole and peri-incisional mezlocillin to prevent wound infection following appendicectomy. The results show that bactericidal local tissue levels of mezlocillin were uniformly achieved using the peri-incisional technique. The wound infection rate (...) for the metronidazole group was found to be 15.9% and did not significantly differ from the wound infection rate when mezlocillin was used (10.4%). Peri-incisional mezlocillin therefore appears to be a viable prophylactic technique against wound infection following appendicectomy and may offer a cheaper alternative to intravenous intra-operative metronidazole administration in cases when pre-operative metronidazole suppositories have been omitted. The peri-incisional mezlocillin technique is also suitable

1985 The Journal of hospital infection Controlled trial quality: uncertain

28067. A clinical trial of teicoplanin compared with a combination of flucloxacillin and tobramycin as antibiotic prophylaxis for cardiac surgery: the use of a scoring method to assess the incidence of wound infection. (Abstract)

A clinical trial of teicoplanin compared with a combination of flucloxacillin and tobramycin as antibiotic prophylaxis for cardiac surgery: the use of a scoring method to assess the incidence of wound infection. A prospective randomized clinical trial is in progress to compare the efficacy of teicoplanin with flucloxacillin and tobramycin in the prevention of endocarditis and wound infection following cardiac surgery. To date, 198 patients have completed the trial, of whom 95 have received (...) teicoplanin and 103 flucloxacillin and tobramycin. One patient developed prosthetic valve endocarditis 3 months after surgery covered by flucloxacillin and tobramycin. There was no significant difference in the incidence of sternal wound infection (P = 0.15). Severe sternal sepsis occurred in four patients in the teicoplanin group and two in the flucloxacillin/tobramycin group. There were more postoperative urinary tract infections among those given teicoplanin (15 of 95 patients compared to six of 103

1986 The Journal of hospital infection Controlled trial quality: uncertain

28068. Single-dose antibiotic prophylaxis of abdominal surgical wound infection: a trial of preoperative latamoxef against peroperative tetracycline lavage. Full Text available with Trip Pro

Single-dose antibiotic prophylaxis of abdominal surgical wound infection: a trial of preoperative latamoxef against peroperative tetracycline lavage. A randomized controlled clinical trial was undertaken in 542 consecutive emergency and elective abdominal operations, with one group of patients receiving tetracycline peritoneal and wound lavage and the other a single intravenous injection of 1 g latamoxef at induction of anaesthesia. Seventy-five patients were withdrawn because no potentially (...) contaminated hollow viscus was opened, and a further 36 because they could not be assessed for wound infection. Of the remaining 431 patients, 212 received latamoxef resulting in 5 major and 8 minor wound infections in hospital; another 4 minor infections occurred at home (total incidence 8.0%). In the tetracycline group (n = 219) there were 7 major and 19 minor wound infections in hospital and 10 minor infections later (total incidence 16.4%). This is significantly higher than the rate with latamoxef (P

1986 Journal of the Royal Society of Medicine Controlled trial quality: uncertain

28069. Single-dose v. short-term antibiotic therapy for prevention of wound infection in general surgery. A prospective, randomized double-blind trial. (Abstract)

Single-dose v. short-term antibiotic therapy for prevention of wound infection in general surgery. A prospective, randomized double-blind trial. To investigate the effectiveness of a single-dose antibiotic regimen for preventing postoperative wound infection, a prospective, randomized double-blind trial was carried out in patients undergoing "clean-contaminated", "contaminated" or "clean" (vascular) surgery. Both elective and emergency operations were included. Single-dose (preoperative (...) ) prophylaxis was compared with short-term prophylaxis (1 dose preoperatively and 2 doses postoperatively). The antibiotics were penicillin, tobramycin and metronidazole in various combinations, and comparisons between single-dose and short-term prophylaxis were made with all the regimens. The incidence of wound infection was 5/277 (1.8%) in the short-term group and 9/287 (3.1%) in the single-dose group. The difference was not statistically significant. Nor was statistically significant difference found

1987 Acta chirurgica Scandinavica Controlled trial quality: uncertain

28070. The effect of washing with chlorhexidine soap on wound infection rate in general surgery. A controlled clinical study. (Abstract)

The effect of washing with chlorhexidine soap on wound infection rate in general surgery. A controlled clinical study. Postoperative wound infections in clean surgery were studied to compare the effect of preoperative whole body disinfection with chlorhexidine soap with that of local washing and no washing at all, respectively. The study includes 1530 operations for biliary tract disease, inguinal hernia and breast cancer. The overall infection rate was 3.4%. Among patient who had (...) a preoperative shower with Chlorhexidine the wound infection rate was significantly reduced.

1987 Annales chirurgiae et gynaecologiae Controlled trial quality: uncertain

28071. Single dose mezlocillin versus three dose cefuroxime plus metronidazole for the prophylaxis of wound infection after large bowel surgery. (Abstract)

Single dose mezlocillin versus three dose cefuroxime plus metronidazole for the prophylaxis of wound infection after large bowel surgery. A prospective, randomized, controlled trial was conducted in 116 consecutive patients undergoing colorectal surgery to compare single dose prophylaxis with mezlocillin to cefuroxime plus metronidazole in three doses. Patients were randomized to receive either a single dose of iv mezlocillin (5.0 g) or three doses of iv cefuroxime plus metronidazole at 8 (...) -hourly intervals. The first dose was given on the operating table. The overall wound infection rate in the mezlocillin treated patients (n = 54) was 30% and in the patients treated with cefuroxime plus metronidazole (n = 56) 25%. This difference is not statistically significant. When trivial wound infections were disregarded the wound infection rates were 11% and 16% respectively, which again was not statistically significant.

1987 The Journal of hospital infection Controlled trial quality: uncertain

28072. A placebo-controlled trial of the effect of two preoperative baths or showers with chlorhexidine detergent on postoperative wound infection rates. (Abstract)

A placebo-controlled trial of the effect of two preoperative baths or showers with chlorhexidine detergent on postoperative wound infection rates. The effect of preoperative whole-body washing with chlorhexidine detergent on the incidence of postoperative wound infection was assessed in a placebo-controlled trial of 1989 patients. Patients bathed or showered with chlorhexidine, placebo, or conventional bar soap, on two occasions in the 24 h before operation. The overall infection rate (...) for patients treated with chlorhexidine was 9%, against 12.8% in the bar soap and 11.7% in the placebo groups; in the 'clean' surgery group infections were 7.2% against 10.2% and 10%, respectively. The Staphylococcus aureus infection rate in the 'clean' group was 3% for chlorhexidine against 6% for bar soap.

1987 The Journal of hospital infection Controlled trial quality: uncertain

28073. Wound infection following dog bite despite prophylactic penicillin. (Abstract)

Wound infection following dog bite despite prophylactic penicillin. Dog bite wounds of 39 children (ages one to 16 years) were cultured and irrigated. Cultures showed various organisms but were of no predictive value for development of infection. By using a table of random numbers, patients were assigned to either oral penicillin V-K (100,000 U/kg/day every 6 h) or placebo for two days. All patients were seen in follow-up in three to four days and again at seven to 10 days or earlier if signs (...) of inflammation occurred. The mean patient age, location and type of wound, and initial wound care were similar in the two treatment groups. Three of 39 (7.7%) children enrolled in the study developed infection at the bite site, including two of 19 in the penicillin group and one of 20 in the placebo group. In our study, prophylactic penicillin failed to prevent infection in dog bite wounds. Good local care on presentation seems to be the most important factor in determining future infection.

1986 Infection Controlled trial quality: uncertain

28074. Preoperative intraincisional cefamandole reduces wound infection and postoperative inpatient stay in upper abdominal surgery. Full Text available with Trip Pro

Preoperative intraincisional cefamandole reduces wound infection and postoperative inpatient stay in upper abdominal surgery. The use of preoperative intraincisional (POII) single dose antibiotic prophylaxis has the advantage of providing extremely high concentrations of antibiotic along all layers of the wound, whilst achieving adequate systemic concentrations throughout the operation. In a single blind controlled trial, 250 patients undergoing upper abdominal surgery were randomised (...) to receive POII cefamandole (2g) or to act as control. There was one wound infection in the POII group compared with 18 in the control group (P less than 0.001). Hospital stay was reduced by an average of one day (P less than 0.02) in the antibiotic treated group.

1985 Annals of the Royal College of Surgeons of England Controlled trial quality: uncertain

28075. [Effectiveness of ofloxacin in the treatment of wound infections]. (Abstract)

[Effectiveness of ofloxacin in the treatment of wound infections]. Ofloxacin (OFX) and doxycycline (D) were compared in an open randomized study in the treatment of wound infections, including soft tissue, traumatic and postoperative wound infections caused by gram-positive as well as gram-negative pathogens. Doses were 2 X 200 mg/day of OFX (n = 21) and 2 X 100 mg/day of D (n = 20). In three cases from the OFX group, the daily dose was successfully increased to 2 X 300 mg. Clinical cure (...) was observed in 20 of 21 patients on OFX and in 12 of 20 patients on D. One patient who failed to respond clinically in the OFX group showed moderately severe gastric pain (possibly drug-related), but by the time this adverse effect became evident, the wound exudate had already cleared bacteriologically. In this study OFX proved to be highly effective in the treatment of wound infections, and it was also well tolerated. Not only did symptoms disappear more frequently under OFX than under D, but they also

1986 Infection Controlled trial quality: uncertain

28076. Intraincisional antibiotic in addition to systemic antibiotic treatment fails to reduce wound infection rates in contaminated abdominal surgery. A controlled clinical trial. (Abstract)

Intraincisional antibiotic in addition to systemic antibiotic treatment fails to reduce wound infection rates in contaminated abdominal surgery. A controlled clinical trial. One hundred ninety patients with peritonitis at the time of abdominal surgery were allocated at random to systemic antibiotic treatment alone or systemic antibiotic treatment combined with topical application of antibiotics in the wound at the time of wound closure. The overall wound infection rate was 17 percent without

1989 Diseases of the colon and rectum Controlled trial quality: uncertain

28077. Failure of topically applied antibiotics, added to systemic prophylaxis, to reduce perineal wound infection in abdominoperineal excision of the rectum. (Abstract)

Failure of topically applied antibiotics, added to systemic prophylaxis, to reduce perineal wound infection in abdominoperineal excision of the rectum. In a prospective, randomized trial, prophylactic use of topical antibiotics in addition to systemic prophylaxis was studied in patients undergoing abdominoperineal amputation of the rectum. All patients received gentamicin 80 mg and metronidazole 500 mg intravenously at induction of anesthesia, followed by the same dose 8 hourly for 48 hours (...) . In accordance with the randomization, half of the patients were additionally given gentamicin 160 mg + metronidazole 400 mg topically into the perineal wound at closure. Perineal wound infection appeared in 19 of the 41 patients who received both systemic and topical prophylaxis, and in 18 of the 38 with only systemic antibiotics. Cell-mediated immunity was preoperatively assessed with a skin test (Multitest) in all but three patients. Impairment of cell-mediated immunity was associated with significantly

1988 Acta chirurgica Scandinavica Controlled trial quality: uncertain

28078. [Wound infection following appendectomy. Metronidazole vs ornidazole as single-dose prophylaxis in non-perforated appendix]. (Abstract)

[Wound infection following appendectomy. Metronidazole vs ornidazole as single-dose prophylaxis in non-perforated appendix]. In an open prospective randomized study, the postoperative wound infection rate following removal of an unperforated appendix was evaluated in 187 patients who received either metronidazole (1 g suppositories) or ornidazole (500 mg iv or 500 mg suppositories) in a single dose preoperatively. The overall postoperative infection rate was 2.1%. Metronidazole and ornidazole (...) suppositories are a cheap method of preventing postoperative infection in cases of unperforated appendix.

1988 Schweizerische medizinische Wochenschrift Controlled trial quality: uncertain

28079. Single-dose clavulanate-potentiated amoxycillin versus three-dose cefotaxime in the prevention of wound infection following elective cholecystectomy: a prospective randomized study. (Abstract)

Single-dose clavulanate-potentiated amoxycillin versus three-dose cefotaxime in the prevention of wound infection following elective cholecystectomy: a prospective randomized study. A prospective randomized study was carried out to evaluate the efficacy of clavulanate-potentiated amoxycillin with that of cefotaxime as prophylactic agents for the prevention of sepsis following elective cholecystectomy. One hundred patients were randomized into two treatment groups. In the first group, each (...) patient received a single intravenous dose (1200 mg) of clavulanate-potentiated amoxycillin 2 h before surgery. In the second group, patients were given intravenous cefotaxime, in three doses (2 g each) during surgery, and 6 and 12 h after their operation. No case of serious post-operative sepsis occurred in either group. Superficial wound infection occurred in 2% of patients receiving a single pre-operative dose of clavulanate-potentiated amoxycillin and in 6% of those given cefotaxime according

1988 The Journal of international medical research Controlled trial quality: uncertain

28080. Determinants of wound infection incidence after isolated coronary artery bypass surgery in patients randomized to receive prophylactic cefuroxime or cefazolin. (Abstract)

Determinants of wound infection incidence after isolated coronary artery bypass surgery in patients randomized to receive prophylactic cefuroxime or cefazolin. In this open-label, randomized drug study, we compared two cephalosporin prophylactic regimens, one using cefazolin and one using cefuroxime, in 100 patients having coronary bypass surgery. Additional epidemiological data were collected to identify the patient at higher risk for acquiring an infection. Patients were categorized into four (...) groups: (1) no infection; (2) clinically determined infection without a culture or prescription of additional antibiotics; (3) clinical infection with no or negative wound culture and prescription of additional antibiotics; and (4) clinical infection with positive culture and need for additional antibiotics. Seven cefuroxime patients (13.5%) and 9 cefazolin patients (18.8%; p = 0.471) had a wound that became clinically infected (Groups 2-4). In a univariate analysis, 11 variables were statistically

1988 The Annals of thoracic surgery Controlled trial quality: uncertain

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