Literature Review of Timing of Prophylactic Antibiotics: One Hour Prior Surgical Incision

My practical competencies have been obtained through working with a general and orthopaedic surgeon. Whilst working with my clinical supervisor, (a consultant orthopaedic surgeon) we decided it would be beneficial to review orthopaedic wound infections. I chose to concentrate on wound infections during a Total Hip Replacement (THR). Wound infections is a massive subject so I have selected specific areas to look at, which are:

Pain…fever…oozing pus. Who would want to experience that? The answer is no one. Yet, out of the sixty to seventy of women who undergo a cesarean section, twelve percent will experience these symptoms due to a surgical site infection (SSI) ("Adjunctive Azithromycin Prophylaxis for Cesarean Delivery", 2017). SSI are the primary cause of mortality and morbidity amongst cesarean section women. SSI are linked to increased length of stay, hospitalization rate, and healthcare costs. Many cases of SSIs are preventable with appropriate preoperative preparation and surgical technique (McKibben et. al, 2015). One specific prophylactic method is the use of antibiotics preoperatively. Using an EBP model, PICO,

Hospital acquired infections (HAI) are never good. Moreover, according to the Centers for Disease Control and Prevention, one in 25 patients will develop an infection which was procured during their stay in a hospital (Centers for Disease Control and Prevention, 2015). Twenty percent of these HAI are due to staphylococcus aureus, better known as simply Staph (Statisticbrain.com, 2015).

More than one million of Healthcare associated infections happen across healthcare settings every year, or 1 in 20 people admitted to any healthcare setting (Healthy people 2020, 2013). HAIs are the most common complication seen in hospitalized patients. HAIs increase morbidity, mortality, healthcare costs, and length of stay even after adjustment for the main underlying illness. According to the Center for Diseases Control (CDC, April 2013) 5 to 10% of patients admitted to acute-care hospitals, or long-term care facilities approximately 2 million patients per year in the United States acquire a nosocomial infection. At least 90,000 deaths per year are a result of HAIs, making it the fifth leading cause of death in acute-care hospitals. These

There are many kinds of healthcare associated infections such as Methicillin-Resistant Staphylococcus Aureus (MRSA), Clostridium difficile (C difficile), pneumonia, Catheter associated Urinary Tract Infection (UTI), surgical site infection, and Central Line-Associated Blood Stream Infection (CLABSI).

“I have neither given nor received help on this assignment, and pledge this work to be my original composition.” –Ashley Salinas

There are different types of nosocomial or healthcare associated infections. These are categorized according to the site of infection and they include pneumonia, gastrointestinal illness, urinary tract infections, bloodstream infections, and surgical site infections (CDC, 2015). This paper seeks to review the current practice of surgical site infection prevention protocol as well as seeks to proffer recommended

The post operative infection rate for patients having surgeries has slowly increased over the last several years and preventing surgical site infections (SSIs) has become a priority with many surgeons. The studies reviewed for this research have stressed the importance of prophylactic antibiotic therapy (Stefansdottir, et al. 2009) and that the timing of this dose being given is becoming the utmost importance; along with the importance of appropriate antibiotic being given. There is not a large study found for the need of post operative antibiotic therapy to be given, the studies found show that there is a question of the effect of the antibiotics after 24-48 hours post procedure. Surgical Practice (2006) reported of a study done in the

We all know that with surgeries there is always a chance of complications that may occur, whether it’d be during, or after. The HAIs, Health Care-Associated Infections one of the most common infections are Post-operative in the healthcare system, these are known as Surgical Site Infections (SSI). According to the Centers for Disease Control and Prevention (CDC) about 1 to 3 out of almost every patient that has surgery an infection does develop (FAQS about Surgical Site Infections)

Studies have proven that antibiotic prophylaxis reduce the risk of wound infection in hip fracture and also the chances of urinary tract infection.(Management Of Hip Fracture In Older People,2009)

In 1992, CDC revised its definition of ‘wound infection’, by creating the definition, ‘surgical site infection’, to prevent the confusion between the infection of a surgical incision and the infection of a traumatic wound (Horan et al 1992). A precise definition of surgical site infection is vital for personnel measuring infection rates (WHO 2009). The definitions of surgical site infection may vary between research studies but are commonly based on those described by the Centers for Disease Control and Prevention although other valid measures have been used (NICE 2008). The CDC definition describes three levels of SSI:

On admission, all patients received intravenous broad spectrum antibiotic as soon as the diagnosis of ACC was established. When

AHC antimicrobial stewardship program 2014: this audit examined the use of intraoperative antibiotics used by anaesthetists. I was involved in creating local guidelines for intraoperative antibiotics. I presented this information to the regional anaesthetists with Chief Pharmacist Ms

Ethical challenges are the most profound when dealing with patient safety; compliance with the prophylaxis antibiotic administration guidelines is paramount to a surgical patient in order to decrease the possibility of a post operative surgical site infection. Antibiotic timing requires

Postoperative surgical site infections according to Nichol (2001) remain a major source of illness in surgical patients. Beaver, (2008) point out that surgical infection is one of the side effects that occur after a patient has gone for surgery.