Title: O papel do antibiótico profilaxia na infecção de sítio cirúrgico em mamoplastia redutora
Abstract: BACKGROUND: Considered a clean surgery, breast surgery presents in the literature with surgical site infection rates (SSI) ranging from 4 to 18%, higher than the reference values (<3.4%). The aim of this study is to measure the incidence of SSI in patients undergoing reduction mammoplasty with and without trans-operative antibiotic prophylaxis, comparing the results and defining the antibiotic prophylaxis value. METHODS: The study was prospective, randomized, double-blinded and interventional. Two groups were formed randomly with 75 patients each: group 1 with prophylactic antibiotics cefazolin 2g 30 minutes before the surgery and reapplication of cefazolin 1g
every 3 hours trans operatory; and the second control group without antibiotic
prophylaxis. Patients were followed up until the 30th POD for identification of SSI. RESULTS: There were 13 cases of surgical site infection, 3 (4.1%) in group 1 and 10 (13.9%) in group 2 control, statistically significant with p = 0.039 . The secretion cultures were positive for Staphylococcus aureus. Regarding the resected volumes, there was more cases of SSI in higher strata (n = 9), with resections bigger than 1201g, but not reaching statistical significance (p = 0.051). DISCUSSION: The study found an incidence of surgical site infection of 9%, well above the arbitrated to clean surgeries (<3.2%) but consistent with the studies reviewed. The use of a cephalosporin (Cefazolin) was determined by germs preferably found in breast surgery, the most common being Staphylococcus aureus. Infection rates observed (group 1 (4.1%) and group 2 (13.9%)) demonstrated the significance of antibiotic trans-operative prophylaxis
(p = 0.039). The comparison with the literature shows hampered by a lack of
randomized controlled trials, inadequate description of the exclusion criteria / withdrawal as well as failures in the masking mechanism (double-blind). CONCLUSION: The antibiotic prophylaxis became adequate and contributed statistically significant in reducing SSI from 13.9% to 4.1%.
Publication Year: 2016
Publication Date: 2016-12-16
Language: en
Type: dissertation
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