What question did this study set out to answer?

To evaluate whether extending perioperative antibiotic prophylaxis from 1 day to 5 days reduces wound infection rates in patients undergoing major contaminated head and neck surgery requiring flap reconstruction.

December 1, 1986Otolaryngology

Antibiotic Prophylaxis in High‐Risk Head and Neck Surgery: One‐Day vs. Five‐Day Therapy

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Why the study?

Does 5-day cefoperazone sodium therapy reduce wound infection compared to 1-day therapy in patients undergoing major contaminated head and neck surgery with pedicled flap reconstruction?

Population

109 evaluable patients undergoing major contaminated surgery of the head and neck requiring pedicled flap…

Comparison

Cefoperazone sodium intravenously for 120 hours… vs Cefoperazone sodium intravenously for 24 hours…

Design

RCT, randomly assigned, double-blind

Authors

JJJonas T. JohnsonUniversity of Pittsburgh DSDavid E. SchullerUniversity of Southern California FSFred SilverNational Medical Research Center of Dentistry and Maxillofacial Surgery

Discussion

Member takes

Implication

Supports 1-day over 5-day prophylaxis without increased infections in flap reconstruction; confirms no benefit from prolonged antibiotics in this setting.

Key Points

To evaluate whether extending perioperative antibiotic prophylaxis from 1 day to 5 days reduces wound infection rates in patients undergoing major contaminated head and neck surgery requiring flap reconstruction.
Conducted a multi-institutional prospective randomized double-blind clinical trial in 109 evaluable surgical patients requiring pedicled flap reconstruction.
Administered intravenous cefoperazone sodium starting 1 to 2 hours preoperatively and continued prophylaxis for either 24 hours (n=53) or 120 hours (n=56).
Wound infection occurred in 10 of 53 patients (18.9%) receiving 24-hour prophylaxis compared with 14 of 56 patients (25%) receiving 120-hour prophylaxis (P > .05).
Extending antibiotic administration beyond 24 hours postoperatively demonstrated no statistically significant benefit in reducing wound infection rates after myocutaneous flap reconstruction.

Structured PICO

Does 5-day cefoperazone sodium therapy reduce wound infection compared to 1-day therapy in patients undergoing major contaminated head and neck surgery with pedicled flap reconstruction?

Population

109 evaluable patients undergoing major contaminated surgery of the head and neck requiring pedicled flap reconstruction.

Intervention

Cefoperazone sodium intravenously for 120 hours (5 days), beginning 1 to 2 hours preoperatively.

Comparator

Cefoperazone sodium intravenously for 24 hours (1 day), beginning 1 to 2 hours preoperatively.

Outcome

Wound infection

Five days of perioperative antibiotic prophylaxis with cefoperazone sodium provides no additional benefit over one day in preventing wound infections for patients undergoing myocutaneous flap reconstruction.

Cite This Study

Johnson et al. (1986) studied this question.

synapsesocial.com/papers/6a76ae6fa0f93219c4ec2d6c https://doi.org/10.1177/019459988609500506

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Implication

Supports 1-day over 5-day prophylaxis without increased infections in flap reconstruction; confirms no benefit from prolonged antibiotics in this setting.

Antibiotic Prophylaxis in High‐Risk Head and Neck Surgery: One‐Day vs. Five‐Day Therapy

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Antibiotic Prophylaxis in High‐Risk Head and Neck Surgery: One‐Day vs. Five‐Day Therapy

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Also Consider

Also Consider