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Related Experiment Videos

Single dose prophylaxis in elective cholecystectomy. A prospective, double-blind randomized study.

Z Kaufman, A Dinbar

    American Journal of Surgery
    |November 1, 1986
    PubMed
    Summary

    A single dose of prophylactic gentamicin significantly reduced wound infections following elective cholecystectomy compared to placebo. This antibiotic prophylaxis is recommended for all patients undergoing this common surgical procedure.

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    Area of Science:

    • Surgical Infection Prevention
    • Clinical Pharmacology
    • Gastrointestinal Surgery

    Background:

    • Elective cholecystectomy is a common surgical procedure.
    • Wound infections are a potential complication following cholecystectomy.
    • Identifying patients at risk for wound infection preoperatively can be challenging.

    Purpose of the Study:

    • To evaluate the efficacy of a single prophylactic dose of gentamicin in preventing wound infections after elective cholecystectomy.
    • To compare the incidence of wound infection in patients receiving gentamicin versus placebo.

    Main Methods:

    • A double-blind, controlled, randomized study was conducted.
    • 102 patients received a single dose of gentamicin (treatment group).
    • 74 patients received a placebo (control group).

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  • Patients identified as high-risk preoperatively were excluded from the study.

    • Main Results:

    • The wound infection rate was 4.9% in the gentamicin group versus 13.5% in the placebo group.
    • In patients with positive bile cultures, the wound infection rate was 14% (gentamicin) vs. 44% (placebo).
    • None of the patients who underwent unexpected choledochus exploration in the gentamicin group developed wound infections, compared to 50% in the placebo group.

    Conclusions:

    • Single-dose prophylactic gentamicin is effective in reducing wound infections after elective cholecystectomy.
    • The study identified that 30% of patients have unidentifiable preoperative risk factors for wound infection.
    • Single-dose gentamicin prophylaxis is recommended for all patients undergoing cholecystectomy.