Perioperative infection prophylaxis in vascular surgery--a randomized prospective study

In 300 reconstructive arterial operations of the abdominal aorta and the lower limbs, a randomized prospective study of the effect of perioperative infection prophylaxis with antibiotics was performed. The evaluation was carried out with regard to the frequency of severe postoperative wound infections. As prophylactic antibiotic Cefuroxime was initially used, Cefotaxim was later administered. Cefotaxim has been proven to be the appropriate antibiotic against the special microbial spectrum of our clinic. Side effects or complications due to the antibiotics were not found. Wound infections of all grades of seriousness occurred in the group without infection prophylaxis in 15.1%, in the antibiotic group in 3% (p less than 0.001). Serious wound infection endangering or involving the transplant were found in the group without prophylaxis in 7.2%, whereas in the antibiotic group in 1.5%. Infections of the vascular prosthesis were observed in 2.4% and 0.8% respectively. Most wound infections occurred in the groin. The most common infecting organisms were Staphylococcus aureus or epidermidis. A higher risk of wound infections due to old age or gangrene could not be observed. Although wound infections in peripheral vascular surgery are relatively rare, they have severe consequences. It is therefore advisable to administer perioperative infection prophylaxis which significantly reduces this complication, especially in patients with synthetic implants.