Korean J Neurotrauma.  2012 Oct;8(2):104-109. 10.13004/kjnt.2012.8.2.104.

Efficacy of Short-Term versus Long-Term Post-Operative Antimicrobial Prophylaxis for Preventing Surgical Site Infection after Clean Neurosurgical Operations

• Ha JS
• Oh SM
• Kang JH
• Cho BM
• Park SH

• KMID: 1427720
• DOI: http://doi.org/10.13004/kjnt.2012.8.2.104

Abstract

OBJECTIVE
Surgical site infection (SSI) is a problem constantly uppermost in the minds of all surgeons, although the actual rate of occurrence is only 1-5% in general surgery. In neurosurgical fields, there have been a few papers published about efficacy of post-operative antimicrobial prophylaxis (PAMP) to prevent SSI, compared to well known effectiveness of pre-operative antibiotics. Thus, infection rates of short-term PAMP groups and those of long-term PAMP groups were investigated to evaluate the effectiveness of PAMP and the efficacy of short-term PAMP compared to long-term PAMP for prevention of SSI.
METHODS
Between April 2010 and April 2012, we retrospectively analyzed the data of 35 patients in the aneurysmal neck clipping groups (short-term PAMP group: PAMP for 3 days and fewer, long-term PAMP group: PAMP for 10 days and more) and 79 patients in the microdiscectomy groups (short-term PAMP group: 3 days and fewer, long-term PAMP group: PAMP for 6 days and more).
RESULTS
In aneurysmal neck clipping groups, SSI occurred 23.1% of short-term PAMP group and 9.1% of long-term PAMP group (p=0.3370). And in microdiscectomy groups, SSI occurred 6.7% of short-term PAMP group and 4.1% of long-term PAMP group (p=0.9840).
CONCLUSION
There is no significant difference between the short-term PAMP group and the long-term PAMP group in terms of SSI, regardless of operation type. We therefore suggest that short-term PAMP usage could be an appropriate therapy for preventing SSI in clean neurosurgical operations.

Keyword

Antibiotic prophylaxis; Surgical wound infection; Neurosurgical procedure

MeSH Terms

Aneurysm
Anti-Bacterial Agents
Antibiotic Prophylaxis
Humans
Neck
Neurosurgical Procedures
Retrospective Studies
Surgical Wound Infection
Anti-Bacterial Agents

Figure

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  FIGURE 1. Patient population profile. PAMP inappropriate duration: patient who prescribed post-operative antibiotics from 4 days to 9 days after surgery in aneurysmal neck clipping group and patient who prescribed post operative antibiotics from 4 days to 6 days after surgery in microdiscectomy group. PAMP: post operative antimicrobial prophylaxis.

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  FIGURE 2. Operation time of group A.

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  FIGURE 3. Operation time of group B.

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