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Antibiotic prophylaxis in lower limb amputation.

B N Møller, B Krebs

    Acta Orthopaedica Scandinavica
    |August 1, 1985
    PubMed
    Summary
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    One-day prophylactic Meticillin therapy significantly reduced postoperative wound infections and re-amputations in lower-limb amputations for ischemia. This antibiotic approach prevented infections, including Staphylococcus aureus, and gas gangrene in surgical patients.

    Area of Science:

    • Infectious Diseases
    • Surgical Infections
    • Antibiotic Prophylaxis

    Background:

    • Lower-limb amputation for ischemia is associated with a high risk of postoperative wound infections.
    • Staphylococcus aureus is a common pathogen in these infections.
    • Effective prophylactic strategies are crucial to minimize complications.

    Purpose of the Study:

    • To evaluate the efficacy of a 1-day prophylactic Meticillin regimen in preventing surgical site infections following lower-limb amputation for ischemia.
    • To compare infection rates and subsequent complications between patients receiving prophylactic antibiotics and a control group.

    Main Methods:

    • Prospective study involving 50 patients undergoing lower-limb amputation for ischemia.
    • Treatment group (27 patients) received intravenous Meticillin (1g X 4) on the day of operation.

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  • Control group (23 patients) received no prophylactic antibiotics.

    • Main Results:

    • None of the Meticillin group patients developed postoperative wound infections, compared to eight in the control group.
    • Seven patients in the control group required re-amputation due to infection.
    • Staphylococcus aureus was prevalent preoperatively and in postoperatively infected stumps in the control group; one control patient developed gas gangrene.

    Conclusions:

    • A 1-day prophylactic Meticillin therapy is highly effective in preventing surgical wound infections after lower-limb amputation for ischemia.
    • This antibiotic strategy significantly reduces the need for re-amputation and associated complications.
    • Prophylactic Meticillin should be considered as a standard of care in this patient population.