surgical prophylaxis siva PPT final

ANTI-MICROBIAL SURGICAL PROPHYLAXIS : 

ANTI-MICROBIAL SURGICAL PROPHYLAXIS Prepared & Presented by Dr. Siva Reddy Challa, Professor & HOD, Dept. of Pharmacology KVSR Siddhartha College of Pharmaceutical Sciences, Siddhartha Nagar, Vijayawada-520010 Andhra Pradesh, INDIA Email: sivareddypharma@gmail.com

Necessity of surgical prophylaxis: 

Necessity of surgical prophylaxis Infection of the surgical site is quite common but avoidable complication of any surgical procedure. Bacterial contamination of the surgical site is inevitable from the patient’s own flora or the environment.

Criteria for defining the Surgical Site Infections (SSI) : 

Criteria for defining the Surgical Site Infections (SSI) SSI involving the skin or subcutaneous tissue and occurs within the 30 days after operation and shows at least one of the following A) Pain, swelling, redness, heat and tenderness. B) Purulent drainage C) Isolation of organisms from either deep incision or organ incision.

CLASSIFICATION OF OPERATIONS : 

CLASSIFICATION OF OPERATIONS

PowerPoint Presentation: 

OPERATION CLASSIFICATION RISK INDEX 0 RISK INDEX 1 RISK INDEX 2 CLEAN 1.0% 2.3% 5.4% CLEAN CONTAMINATED 2.10% 4.0% 3.5% CONTAMINATED 3.4% 6.8% 13.2%

Prophylaxis: 

Prophylaxis Antibiotic is administered before the intended surgical procedures so that at the time of the incision, there is enough antibiotic to prevent bacterial proliferation. It is commonly bactericidal and given intravenous. Neomycin may be used in bowel preparation for colonic surgery.

PowerPoint Presentation: 

Ideally, an anti-infective drug for surgical prophylaxis should achieve the following goals: Prevent postoperative infection of the surgical site, Prevent postoperative infectious morbidity and mortality, Reduce the duration and cost of health care (when the costs associated with the management of postoperative infection are considered, the cost-effectiveness of prophylaxis becomes evident) Produce no adverse effects, and Have no adverse consequences for the microbial flora of the patient or the hospital.

PowerPoint Presentation: 

To achieve these goals, an anti-infective drug should be Active against the pathogens most likely to contaminate the wound, Given in an appropriate dosage and at a time that ensures adequate concentrations at the incision site during the period of potential contamination, Safe, and Administered for the shortest effective period to minimize adverse effects, development of resistance, and cost. The benefits of preventing postoperative infection pertain to both outpatient and inpatient surgeries. For most procedures , cefazolin should be the agent of choice because of its relatively long duration of action, its effectiveness against the organisms most commonly encountered in surgery, and its relatively low cost

Antimicrobial prophylaxis : 

Antimicrobial prophylaxis Antimicrobial prophylaxis is justified for the following types of surgical procedures: cardiothoracic, GI tract (e.g., colorectal and biliary tract operations), head and neck (except clean procedures), neurosurgical, obstetric or gynecologic, orthopedic (except clean procedures), urologic, and vascular. The use of antimicrobials for dirty and contaminated procedures is not classified as prophylaxis

Few guidelines for antibiotic surgical prophylaxis: 

Few guidelines for antibiotic surgical prophylaxis Administer antibiotic(s) as close as possible to time of commencement of operation (within maximum 1 hour from induction) to ensure adequate drug levels. Cefazolin dose for all adult patients, regardless of weight is now 2 grams IV. Repeat the cefazolin dose intraoperatively if the procedure last more than 3 hours. If vancomycin is used, a second intraoperative dose is not required. Post–operative doses are not doses recommended unless specified.

Few recommendations and guidelines for antibiotic surgical prophylaxis: 

Few recommendations and guidelines for antibiotic surgical prophylaxis

Thank You: 

Thank You