Surgical Site Infection and Preoperative Antibiotic Prophylaxis in The Prevention Among Hospitalized Patients

Introduction: Surgical site infection (SSI) is defined as an infection related to an operative procedure that occurs at or near the surgical incision within 30 days of the procedure. Most common cause of post-operative morbidity is surgical site infection (SSI) in planned cases accounting nearly 65% to 80% of all cases in our population. This study was conducted to know the need for antibiotic prophylaxis in clean, clean-contaminated surgical wounds and whether prophylactic antibiotic is itself sufficient to minimize surgical site infection. Methods: This was a prospective study was carried out at Dept. of Surgery, Enam Medical College Hospital, Savar, Bangladesh from July 2022 to June 2023. During this period, 150 cases were selected for our study. The cases were grouped in to two categories; Group A and Group B of 75 cases each. Group A comprises patients who received a pre-operative single dose of ceftriaxone a broad spectrum cephalosporin. Group B received no such prophylactic antibiotic. All were subjected to surgeries done under meticulous surgical technique. Results: Were divided equally into two groups, Group A included 75 cases who received single prophylactic dose of 1 gm of cefotriaxone given intravenously half an hour before surgery and Group B included 75 cases who did not receive any such antibiotic prior to surgery. The incidence of age varied from 5 to 60 years but maximum number of patients belonged to 21 to 30 years age group. Six patients in group B were infected; one belonged to 41-50 years age group three belonged to the 51-60 years age group and other two in the 61-70 years age group. Group A had 50 clean surgical cases and 20 clean contaminated cases, out of which none of them were infected. In group B out of 50 clean cases, 2 cases were infected and out of 30 clean contaminated cases 10 were infected. Our study showed that there is no need for prophylactic antibiotics in cases of clean surgeries. We recommend antibiotic prophylaxis in clean contaminated cases. The incidence of surgical site infection depends on various factors like old age (27.1%), anaemia (30.5%), Diabetes mellitus (25.4%) and prolonged duration of surgery more than 2 hours (14.2%). Conclusions: From this study we can conclude that, in cases of clean surgeries there is no need for prophylactic antibiotics, as there is no statistical significance, whereas in clean contaminated cases antibiotic prophylaxis is recommended as it reduces SSI statistically significant.