Local vs Systemic Antibiotics to Decrease Wound Complications following Vertical Banded Gastroplasty: Results of a...

Area of Science:

• Bariatric Surgery
• Infectious Disease Prevention
• Obesity Medicine

Background:

• Obesity is a known risk factor for surgical wound infections, with reported rates between 1-16%.
• Previous infection rates for morbidly obese patients in this department were 12% without perioperative antibiotics.
• Vertical banded gastroplasty is a bariatric procedure often performed on morbidly obese patients.

Purpose of the Study:

• To compare the efficacy of local gentamicin-collagen fleece versus a single intravenous dose of amoxicillin-clavulanic acid in preventing wound infections.
• To evaluate the impact of different perioperative antibiotic strategies on infection rates in morbidly obese patients undergoing vertical banded gastroplasty.

Main Methods:

• A prospective randomized study involving 50 morbidly obese patients undergoing vertical banded gastroplasty.
• Comparison of two antibiotic regimens: topical gentamicin-collagen fleece versus intravenous amoxicillin-clavulanic acid.
• Standardized surgical techniques, subcutaneous drainage, and follow-up protocols were used for all patients.

Main Results:

• No wound infections, hematomas, or seromas were observed in any of the 50 patients during hospitalization.
• During a median follow-up of 6 months, no patients developed surgical site abscesses.
• Both antibiotic strategies proved effective in preventing wound complications.

Conclusions:

• Perioperative antibiotic management is crucial for achieving low infection rates in morbidly obese patients.
• Both topical gentamicin-collagen fleece and intravenous amoxicillin-clavulanic acid are effective in preventing surgical wound infections in this patient population.
• Optimized antibiotic protocols can significantly improve outcomes for bariatric surgery patients.