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[Perioperative antibiotic prophylaxis in reconstruction of the thoracic wall]
H Rupprecht1, H P Hummer, F Kees
1Univ. Klinik Erlangen.
Insights
Cefotaxime antibiotic effectively prevents infection in pediatric chest reconstruction surgery. High tissue levels in cartilage and bone ensure wound healing and offer value for orthopedic procedures.
Area of Science:
- Pharmacology
- Orthopedic Surgery
- Pediatric Medicine
Context:
- Surgical reconstruction of excavated chest in pediatric patients presents a risk of infection from Staphylococcus and gram-negative bacteria.
- Effective antibiotic prophylaxis is crucial for successful surgical outcomes in pediatric orthopedic procedures.
Purpose:
- To evaluate the efficacy of cefotaxime in preventing surgical site infections during pediatric chest reconstruction.
- To measure cefotaxime and metabolite concentrations in bone and cartilage tissue following administration.
Summary:
- Thirty pediatric patients undergoing chest reconstruction received 100 mg/Kg cefotaxime preoperatively.
- High-performance liquid chromatography (HPLC) confirmed significant cefotaxime levels in cartilage (9.8 mmg/gr) and bone (9.3 mmg/gr) 45 minutes post-administration.
- All patients experienced regular wound healing, indicating successful infection prevention.
Impact:
- The study demonstrates cefotaxime's effectiveness in achieving therapeutic antibiotic levels in pediatric bone and cartilage, crucial for preventing surgical site infections.
- Findings suggest cefotaxime's potential utility in other orthopedic surgeries requiring robust bone and cartilage penetration for infection prophylaxis.
Abstract:
Thirty youngs and children were submitted to surgical reconstruction of excavated chest. To prevent risk of infections (by Staphylococcus and mixed gram-negative flora) preoperative 100 mg/Kg body weight of cefotaxime was given. In all patients the operative wounds healed regularly. To evaluate cefotaxime level and that of its metabolites raised in the tissues, the very sensibles method HPLC was applied. Thus 45 minutes after antibiotic somministration, very high levels were present in cartilage 9.8 mmg/gr and in bones (9.3 mmg/gr). Related to Staphylococcus aureus (MHK 90 of about 2 mmg/ml) results are of value also for other surgical orthopedic operations.