Antimicrobial Prophylaxis Redosing Reduces Surgical Site Infection Risk in Prolonged Duration Surgery Irrespective of...

Area of Science:

• Surgery
• Infectious Diseases
• Pharmacology

Background:

• Long-duration surgeries necessitate repeated antimicrobial prophylaxis (amp) administration to prevent surgical site infections (SSI).
• While amp redosing is known to reduce SSI incidence, it is often omitted in practice.
• The clinical significance of the timing of amp redosing requires further investigation.

Purpose of the Study:

• To evaluate the impact of antimicrobial prophylaxis redosing compliance and its timing on SSI incidence in prolonged duration surgeries.
• To identify key factors associated with increased SSI risk in long-duration surgical procedures.

Main Methods:

• Analysis of data from over 9000 patients undergoing visceral, trauma, or vascular surgery in two Swiss tertiary referral hospitals.
• Inclusion of patients who received preoperative amp and redosing if indicated, with various antibiotic regimens documented.
• Exploration of associations between SSI incidence and parameters including wound class, ASA scores, and duration of operation.

Main Results:

• SSI incidence significantly correlated with the duration of surgery (ρ=0.73, p=0.031).
• In surgeries exceeding 240 minutes, only the duration of surgery was significantly associated with increased SSI risk (p<0.001).
• Antimicrobial prophylaxis redosing significantly reduced SSI incidence (OR 0.60, p=0.034), irrespective of exact timing.

Conclusions:

• Long-duration surgery is associated with a higher incidence of surgical site infections.
• Antimicrobial prophylaxis redosing demonstrates a significant decrease in SSI risk.
• The timing of antimicrobial prophylaxis redosing does not significantly impact SSI reduction; compliance is crucial.