EVALUATING POSTOPERATIVE WOUND INFECTION RATES IN ELECTIVE ABDOMINAL SURGERIES WITH AND WITHOUT PREOPERATIVE ANTIBIOTIC PROPHYLAXIS
DOI:
https://doi.org/10.71000/0zrxwx56Keywords:
Abdominal Surgery, Hospital Stay, Antibiotic Prophylaxis, Postoperative Complications; , Randomized Controlled Trial, Surgical Site Infection, Wound InfectionAbstract
Background: Surgical site infections remain a common postoperative complication following abdominal surgeries, contributing to prolonged hospitalization, increased morbidity, and higher healthcare costs. The role of preoperative antibiotic prophylaxis in preventing such infections has been debated, with concerns regarding both clinical efficacy and antibiotic stewardship.
Objective: To assess how preoperative antibiotics influence postoperative wound infection rates in elective abdominal surgical procedures.
Methods: A randomized controlled trial was conducted over eight months at a tertiary care hospital in South Punjab. A total of 160 patients scheduled for elective abdominal surgeries were randomized into two groups: Group A received preoperative antibiotic prophylaxis, and Group B underwent surgery without prophylactic antibiotics. The primary outcome was the incidence of surgical site infections within 30 days, assessed according to standardized clinical criteria. Secondary outcomes included length of hospital stay and the need for reintervention. Data were analyzed using chi-square tests for categorical variables and independent t-tests for continuous variables, with significance set at p < 0.05.
Results: Surgical site infections occurred in 7.5% of patients in the antibiotic group compared to 20% in the non-antibiotic group. The mean hospital stay was significantly shorter in the antibiotic group (5.2 ± 1.6 days) than in the non-antibiotic group (6.7 ± 2.1 days). Reoperations due to infection were required in 2.5% of patients receiving antibiotics compared to 8.75% in those without prophylaxis.
Conclusion: Preoperative antibiotic prophylaxis substantially reduced postoperative infection rates, shortened hospital stay, and lowered the need for reintervention in elective abdominal surgeries. The findings highlight the importance of incorporating prophylactic antibiotics as a standard preventive measure in surgical practice.
References
Long DR, Cifu A, Salipante SJ, Sawyer RG, Machutta K, Alverdy JCJJs. Preventing surgical site infections in the era of escalating antibiotic resistance and antibiotic stewardship. 2024;159(8):949-56.
Dhole S, Mahakalkar C, Kshirsagar S, Bhargava AJC. Antibiotic prophylaxis in surgery: current insights and future directions for surgical site infection prevention. 2023;15(10).
Hanfi H, Ahmad W, Singh A, Ibrahim M, Ilyaseen A, Iqbal N, et al. Antibiotic Prophylaxis for Preventing Surgical Site Infections After Abdominal Surgery: A Systematic Review.8(S1):705-16.
Eckmann C, Aghdassi SJS, Brinkmann A, Pletz M, Rademacher JJDÄI. Perioperative Antibiotic Prophylaxis: Indications and Modalities for the Prevention of Postoperative Wound Infection. 2024;121(7):233.
Calderwood MS, Anderson DJ, Bratzler DW, Dellinger EP, Garcia-Houchins S, Maragakis LL, et al. Strategies to prevent surgical site infections in acute-care hospitals: 2022 Update. 2023;44(5):695-720.
Njuguna MM. Systematic Review on Effectiveness of Antimicrobial Use for Prevention of Surgical Site Infections and the Use of Antimicrobials Perioperatively in Veterinary Practices in Kenya: University of Nairobi; 2023.
Ellis RJ, Brajcich BC, Bertens KA, Chan CH, Fernandez-del Castillo C, Karanicolas PJ, et al. Association between biliary pathogens, surgical site infection, and pancreatic fistula: results of a randomized trial of perioperative antibiotic prophylaxis in patients undergoing pancreatoduodenectomy. 2023;278(3):310-9.
Wang Q, Cao M, Tao H, Fei Z, Huang X, Liang P, et al. Evidence‐based guideline for the prevention and management of perioperative infection. 2023;16(1):50-67.
Staicovici S, Sârbu V, Gheorghe E, Deacu S, Vlase I, Ispas S, et al. Effectiveness of Continuing Post-Surgery Antibiotic Prophylaxis in Reducing Nosocomial Infections—A Literature Review. 2023;118(4):358.
Seidelman JL, Mantyh CR, Anderson DJJJ. Surgical site infection prevention: a review. 2023;329(3):244-52.
Sartelli M, Boermeester MA, Cainzos M, Coccolini F, de Jonge SW, Rasa K, et al. Six long-standing questions about antibiotic prophylaxis in surgery. 2023;12(5):908.
Fiore M, Corrente A, Di Franco S, Alfieri A, Pace MC, Martora F, et al. Antimicrobial approach of abdominal post-surgical infections. 2023;15(12):2674.
Khan OH, Zakaria AD, Hashim MN, Khan AH, AlQarni A, AlGethamy M, et al. The burden of surgical site infection at Hospital Universiti Sains Malaysia and related postoperative outcomes: A prospective surveillance study. 2023;12(2):208.
ur Rehman H, Iqbal A, Ahmad I, Fayyaz H, Ali L, Iqbal J, et al. Exploring the impact of risk factors, preventive measures, and management strategies on surgical site infections in general surgery: a comprehensive assessment. 2024;36(2):364-8.
Bielicki I, Schmid H, Atkinson A, Kahlert CR, Berger C, Troillet N, et al. Association between perioperative prophylaxis with cefuroxime plus metronidazole or amoxicillin/clavulanic acid and surgical site infections in paediatric uncomplicated appendectomy: a Swiss retrospective cohort study. 2023;12(1):106.
Cainzos MA, Dominguez-Comesaña E, González-Rodriguez FJGIP, HEALTHCARE MI. Healthcare-associated infections as patient safety indicators.83.
Rodríguez-Fernández M, Trigo-Rodríguez M, Martínez-Baena D, Herrero R, Espíndola-Gómez R, Martínez Pérez-Crespo P, et al. Role of rectal colonization by third-generation cephalosporin-resistant Enterobacterales on the risk of surgical site infection after hepato-pancreato-biliary surgery. 2024;12(11):e00878-24.
Cho S, Kim Z, Chung D, Cho B, Chung M, Kim J, et al. Development of machine learning models for the surveillance of colon surgical site infections. 2024;146:224-31.
Tan SA, Sanchez JA. Surgical site and other acquired perioperative infections. Handbook of Perioperative and Procedural Patient Safety: Elsevier; 2024. p. 191-204.
Ulasi I, Aigbovo E, Michael A, Ayandipo O, Fowotade A, Ishiyaka U, et al. The effect of skin antisepsis after primary skin closure on the incidence of surgical site infection after abdominal surgery for sepsis: A preliminary report of a randomised controlled trial. 2023;21(3):46-56.
Senagore AJ, Stark Y, Belotserkovsky O, Reichert M, Wasserberg N, Tulchinsky H, et al. Reduction in surgical site infections by localized administration with D-PLEX100 in patients with multiple risk factors undergoing colorectal surgery. 2023;225(3):485-8.
Lechowski S, Kułakowska A, Kłakowicz P, Lepczyński B, Siedlak AJJoE, Health, Sport. Surgical site infections–an updated review of guidelines in the light of new scientific data. 2023;28(1):19-38.
Koudieh M, Al Saif S, Oueida F, Baradai A, Alkhamees K, Otabi A, et al. Prophylactic 24 versus 48 h cephalosporins in cardiac surgery: A randomized trial. 2024;32(8-9):462-71.
Formosa M, Ebejer SJJSON. Prophylactic Negative Pressure Wound Therapy in Reducing Surgical Site Infections: An Evidence-Based Literature Review. 2024;10:23779608241292839.
Downloads
Published
Issue
Section
License
Copyright (c) 2025 Ahmad Hasan Arif, Muhammad Hassam Mehdi, Talha Adil, Muneeb Islam, Ijaz Ahmad , Farhan Muhammad Qureshi (Author)
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
