Abstract
Amaç: Temiz cerrahi işlemlerde, yabancı cisim implantasyonu ve enfeksiyon olasılığının hasta için ciddi sonuçlar doğuracağı ameliyatlarda antimikrobiyal profilaksi kullanımı giderek yaygınlaşmıştır. Ancak, yakın zamanlı bir Cochrane meta-analizi sonucunda antimikrobiyal profilaksinin yama kullanılan ya da yama kullanılmadan gerçekleştirilen kasık fıtığı onarımlarında önerilemeyeceği gibi reddedilemeyeceği de belirtilmiştir. Genel cerrahide, yama kullanılan kasık fıtığı onarımı, en sık uygulanan cerrahi işlemlerden biridir. Bu cerrahi girişimde antimikrobiyal profilaksinin gerekli olup olmadığı konusunun çözümü, profilaktik amaçlı antibiyotik kullanımının yol açtığı maliyet artışından ve bakteriyel direnç gelişimine katkısından dolayı oldukça önemlidir. Literatürdeki yama kullanılan kasık fıtığı onarımlarında antimikrobiyal profilaksinin cerrahi alan efeksiyonları üzerindeki etkisini prospektif randomize kontrollü çalışma tasarımıyla araştıran tüm çalışma sonuçları havuzlandığında, profilaksi grubunda cerrahi alan enfeksiyonu oranı anlamlı olarak daha azdır. Bu nedenle cerrahlar, yama kullanacakları kasık fıtığı onarımlarında antimikrobiyal profilaksi uygulamalıdır. Yerleşik kılavuzlarda da yer alan bu öneriden vazgeçilmesi için henüz güçlü bir kanıt yoktur.
Keywords:
Kasık fıtığı onarımı, temiz cerrahi, yama, antimikrobiyal profilaksi
References
1
Burke JP. Infection control-a problem for patient safety. Engl J Med 2003;348:651-656.
2
National Nosocomial Infections Surveillance (NNIS) report, data summary from October 1986–April 1996, issued May 1996: a report from the National Nosocomial Infections Surveillance (NNIS) System. Am J lnfect Control 1996;24: 380–388.
3
Delgado-Rodriguez M, Sillevo-Arenas M, Mediha- Cuadros M, Martinez-Gallego G. Nosocomial infections in surgical patients: comparison of two measures of intrinsic patient risk. Infect Control Hosp Epidemiol 1997;18:19-23.
4
Horan TC, Culver DH, Gaynes RP, et al. Nosocomial infections in surgical patients in the United States, January 1986–June 1992: National Nosocomial Infections Surveillance (NNIS) System. Infect Control Hosp Epidemiol 1993;14: 73-80.
5
Wallace WC, Cinat M, Gornick WB, et al. Nosocomial infections in the surgical intensive care unit: a difference between trauma and surgical patients. Am Surg 1999;69: 987-990.
6
Auerbach AD. Prevention surgical site infections. In: Shozania KG, Duncan BW, McDonald KM et al, editors. Making health care safer: a critical analysis of patient safety practices. Evidence Report/ Technology Assessment 43. AHRQ Publication 01-EO58. Rockville, MD: Agency for Healthcare Reasearch and Quality; 2001. p. 221-244.
7
Wong ES. Surgical site infection. In: Mayhall DG, editor. Hospital epidemology and infection control. 2nd ed. Lippincott, PA: Williams & Wilkins; 1999. p. 189-210.
8
Kirkland KB, Briggs JP, Trivette SL, et al. The impact of surgical site infections in the 1990s: attributable mortality, excess length of hospitalization and extra costs. Infect Control Hosp Epidemiol 1999;20:725-730.
9
Martone WJ, Jarvis WR, Culver DH, et al. Incidence and nature of endemic and epidemic nosocomial infections. In: Bennett JV, Brachman PS, editors. Hospital infections. 3rd ed. New York: Little, BrownMedical Division; 1992. p. 577-596.
10
Hollenbeak CS, Murphy D, Dunagan WC, et al. Nonrandom selection and the attributable cost of surgical-site infections. Infect Control Hosp Epidemiol 2002;23:174-176.
11
Perencevich EN, Sands KE, Cosgrove SE, et al. Health and economic impact of surgical site infections diagnosed after hospital discharge. Emerg Infect Dis 2003;9:196-203.
12
Jenney AW, Harrington GA, Russo PL, et al. Cost of surgical site infections following coronary artery bypass surgery. Aust NZ J Surg 2001;71:662-664.
13
Whitehouse JD, Friedman ND, Kirkland KB, et al. The impact of surgical site infections following orthopedic surgery at a community hospital and university hospital: adverse quality of life, excess length of stay and extra cost. Infect Control Hosp Epidemiol 2002;23:183-189.
14
Fry DE. The economic cost of surgical site infection. Surg Infect (Larchmt) 2002;3(Suppl 1):337-343.
15
Howard JM, Barker WF, Culbertson WR, et al. Postoperative wound infections: the influence of ultraviolet irradiation on the operating room and of various factors. Ann Surg 1964; 160(Suppl):1-192.
16
Mangram AJ, Horan TC, Pearson ML, et al. Guideline for the prevention of surgical site infection. Infect Control Hosp Epidemiol 1999;20:247-280.
17
Fry DE. Basic aspects of and general problems in surgical infections. Surg Infect (Larchmt) 2001;2(Suppl 1):3-11.
18
Miles AA, Miles EM, Burke J. The value and duration of defense reactions of the skin to the primary lodgement of bacteria. Br J Exp Pathol 1957;38:79-96.
19
Burke JF. The effective period of preventive antibiotic action in experimental incisions of dermal lesions. Surgery 1961;50:161-168.
20
Polk Jr HC, Lopez-Major JF. Postoperative wound infection: a prospective study of determinant factors and prevention. Surgery 1969;66:97-103.
21
Stone HH, Hooper CA, Kolb LD, et al. Antibiotic prophylaxis in gastric, biliary and colonic surgery. Ann Surg 1976;184: 443-492.
22
Polk Jr HC, Trachhtenberg L, Finn MP. Antibiotic activity in surgical incisions: the basis for prophylaxis in selected operations. JAMA 1980;244:1353-1354.
23
Di Piro JT, Vallner JJ, Bowden TA, et al. Intraoperative serum and tissue activity of cefazolin and cefoxitin. Arch Surg 1985;120:829-832.
24
Classen DC, Evans RS, Pestotnik SL, et al. The timing of prophylactic administration of antibiotics and the risk of surgical-wound infection. N Engl J Med 1992;326:281-286.
25
Altemeier WA. Postsurgical infections. Antibiot Chemother 1976;21:11-31.
26
Bergamini TM, Polk Jr HC. The importance of tissue antibiotic activity in the prevention of operative wound infection. J Antimicrob Chemother 1989;23:301-313.
27
Olson MM, Lee JJ. Continuous, 10-year wound infection surveillance. Results, advantages, and unanswered questions. Arch Surg 1990;125:794-803.
28
Dellinger EP, Gross PA, Barrett TL, et al. Quality standard for antimicrobial prophylaxis in surgical procedures: Infectious Diseases Society of America. Clin Infect Dis 1994;18: 422-427.
29
Page CP, Bohnen JM, Fletcher JR, et al. Antimicrobial prophylaxis for surgical wounds: guidelines for clinical care. Arch Surg 1993;128:79-88.
30
Antimicrobial prophylaxis in surgery. Med Lett Drugs Ther 2001;43:92_97[Published erratum in Med Lett Drugs Ther 2001;43:108].
31
ACCOG Committee on Practice Bulletins. Antibiotic prophylaxis for gynecologic procedures. ACOG Practice Bulletin 23. Washington, DC: American College of Obstetricians and Gynecologists; 2001.
32
Gilbert DN, Moellering RC, Sande MA. The Sanford guide to antimicrobial therapy. 33rd ed. Hyde Park, VT: Antimicrobial Therapy Inc.; 2003. p. 123_124.
33
Antimicrobial prophylaxis in surgery. Med Lett Drugs Ther 1999;41:75_80. 34. Bratzler DB, Houck PM, for the Surgical Infection Prevention Guidelines Writers Workgroup. Antimicrobial prophylaxis for surgery: an advisory statement from the National Surgical Infection Prevention Project. CID 2004;38:1706-1715.
34
Terzi C, Kılıc¸ D, U¨nek T, et al. Single-dose oral ciprofloxacin compared with single-dose intravenous cefazolin for prophylaxis in inguinal hernia: a controlled randomized clinical study. J Hosp Infect 2005;60:340-347.
35
Kuzu MA, Hazinedaroglu S, Dolalan S, et al. Prevention of surgical site infection after open prosthetic inguinal hernia repair: efficacy of parenteral versus oral prophylaxis with amoxicillin- clavulanic acid in a randomized clinical trial. World J Surg 2005;29:794-799.
36
Platt R, Zalenik DF, Hopkins CC, et al. Perioperative antibiotic prophylaxis for herniorrhapy and breast surgery. N Engl J Med 1990;322:153-160.
37
Rotstein C, Ferguson R, Cummings KM, et al. Determinants of clean surgical wound infections for breast procedures at an oncology center. Inf Control Hosp Epidemiol 1992;13:207-214.
38
Platt R, Zucker JR, Zaleznik DF, et al. Prophylaxis against wound infection following herniorrhapy of breast surgery. Inf Dis 1992;166:556-560.
39
Yerdel MA, Akın EB, Dolalan S, et al. Effect of single- dose prophylactic ampicillin and sulbactam on wound infection after tension-free inguinal hernia repair with polypropylene mesh. Ann Surg 2001;233:26-33.
40
Boxma H, Broekhuizen T, Pakta P, et al. Randomised controlled trial of single-dose antibiotic prophylaxis in surgical treatment of closed fractures: the Dutch Trauma Trial. Lancet 1996;347:1133-1137.
41
Pitt HA, Postier RG, MacGowan AW, et al. Prophylactic antibiotics in vascular surgery: topical, systemic or both? Ann Surg 1980;192:359-364.
42
DaCosta A, Kirkorian G, Cuccherat M, et al. Antibiotic prophylaxis for permanent pacemaker implantation, a metaanalysis. Circulation 1998;97:1796-1801.
43
Waldwogel FA, Vaudaux PE, Pittet D, et al. Perioperative antibiotic prophylaxis of wound and foreign body infections: microbial factors affecting efficacy. Rev Infect Dis 1991; 13(Suppl):782-789.
44
Kaiser AB. Overview of cephalosporin prophylaxis. Am J Surg 989;155:52-55.
45
Shapiro M, Townsend TR, Rosner B, et al. Use of antimicrobial drugs in general hospitals: patterns of prophylaxis. N Engl J Med 1979;301:351-355.
46
Cainzos M, Lozano F, Balibrea JL. La infection postoperatoria: estudio multicentrico, prospectivo y controlado[postoperative infection: multicentric, prospective and controlled study]. Cir Esp 1990;48:481-490.
47
The EU Hernia Trialists Collaboration. Repair of groin hernia with synthetic mesh. Meta-analysis of randomized controlled trials. Ann Surg 2002;235:322-332.
48
The EU Hernia Trialists Collaboration. Mesh compared with non-mesh methods of open groin hernia repair: systematic review of randomized controlled trials. Br J Surg 2000;87: 854-859.
49
Wrijland WW, van den Tol MP, Luijendijk RW, et al. Randomized clinical trial of non-mesh versus mesh repair of primary inguinal hernia. Br J Surg 2002;89:293-297.
50
Rutkow IM. Demographic and socioeconomic aspects of hernia repair in the United States in 2003. Surg Clin North Am 2003;83:1045-1051.
51
Cruse PJ, Ford R. The epidemiology of wound infection: a 10- year prospective study of 62,939 wounds. Surg Clin North Am 1980;60:27-40.
52
Mann DV, Prout J, Havranek E. Late onset deep prosthetic infection following mesh repair of inguinal hernia. Am J Surg 1998;176:12-14.
53
Taylor SG, O'Dwyer PJ. Chronic groin sepsis following tension-free inguinal hernioplasty. Br J Surg 1999;86: 562-565.
54
Perez AR, Roxas MF, Hilvano SS. A randomized, double-blind, placebo-controlled trial to determine effectiveness of antibiotic prophylaxis for tension-free mesh herniorrhaphy. J Am Coll Surg 2005;200:393-398.
55
Condon RE, Wittmann DH. The use of antibiotics in general surgery. Curr Probl Surg 1991;28:803-907.
56
Woods RK, Dellinger EP. Current guidelines for antibiotic prophylaxis of surgical wounds. Am Fam Physician 1998;58: 2731-2740.
57
Rutkow IM, Robbins AW. Tension-free inguinal herniorrhaphy: a preliminary report on the mesh-plug technique. Surgery 1993;114:3-8.
58
Bailey IS, Karan SE, Toyn K, et al. Community surveillance of complications after hernia surgery. BMJ 1992;304:469-471.
59
Holmes J, Readman R. A study of wound infections following inguinal hernia repair. J Hosp Infect 1994;28:153-156.
60
Wittmann DH, Schein M, Condon RE. Antibiotic prophylaxis in wall hernia surgery: never, always, or selectively? Probl Gen Surg 1995;12:47-55.
61
Amid PK, Shulman AG, Lichtenstein IL. Critical scrutiny of open “tension-free” hernioplasty. Am J Surg 1993;165: 369-371.
62
Lichtenstein IL, Shulman AG, Amid PK. Use of mesh to prevent recurrence of hernias. Postgrad Med 1990;87: 155-158.
63
Lichtenstein IL, Shulman AG, Amid PK, et al. The tensionfree hernioplasty. Am J Surg 1989;157:188-193.
64
Shulman AG, Amid PK, Lichtenstein IL. The “plug” repair of 1402 recurrent inguinal hernias. Arch Surg 1990;125: 265-267.
65
Shulman AG, Amid PK, Lichtenstein IL. Prosthetic mesh plug repair of femoral and recurrent inguinal hernias: the American experience. Ann R Coll Surg Engl 1992;74:97-99.
66
Shulman AG, Amid PK, Lichtenstein IL. Patch or plug for groin hernia: which? Am J Surg 1994;167:331-336.
67
Simchen E, Rozin R, Wax Y. The Israeli study of surgical infection of drains and the risk of wound infection in operations for hernia. Surg Gynecol Obstet 1990;170: 330-337.
68
Taylor EW, Duffy K, Lee K, et al. Surgical site enfection after groin hernia repair. Br J Surg 2004;91:105-111
69
Gilbert AI, Felton LL. Infection in inguinal hernia repair considering biomaterials and antibiotics. Surg Gynecol Obstet 1993;177:126-130.
70
Wantz GE. Experience with tension-free hernioplasty for primary inguinal hernia in men. J Am Coll Surg 1996;183: 351-356.
71
Ranaboldo CJ, Karan SE, Bailey S, et al. Antimicrobial prophylaxis in clean surgery: hernia repair. J Antimicrob Chemother 1993;31(Suppl B):35-41.
72
Sanderson PJ. Assesseng the role of prophylactic antibiotics in clean surgery. J Hosp Infect 1999;42:7-9.
73
Mozilo N, Grico D, Pescini A, et al. Chemoprophylaxis in the surgical ward: results of a national survey in Italy. Eur J Epidemiol 1988;4:357-359.
74
Codina C, Trilla A, Riera N, et al. Perioperative antibiotic prophylaxis in Spanish hospitals: results of a questionnaire survey. Infect Control Hosp Epidemiol 1999;20:436-439.
75
Heineck I, Ferreira MB, Schenkel EP. Prescribing practice for antibiotic prophylaxis for 3 commonly performed surgeries in a teaching hospital in Brasil. Am J Infect Control 1999;27: 296-300.
76
Sanchez-Manuel FJ, Seco-Gil JL. Antibiotic prophylaxis for hernia repair. The Cochrane database of Systemic Reviews; John Wiley & Sons 2004[Issue 4. Art. No.: CD003769.pub2.-doi:10.1002/14651858.CD003769.pub2. This version first published online: 18 October 2004].
77
Andersen JR, Burcharth F, Larsen HW, et al. Polyglycolic acid, silk, and topical ampicillin. Their use in hernia repair and cholecystectomy. Arch Surg 1980;115:293-295.
78
Evans C, Pollock AV. The reduction of surgical wound infections by prophylactic parenteral cephaloridine. A controlled clinical trial. Br J Surg 1973;60:434-437.
79
Lazorthes F, Chiorasso P, Massip P, et al. Local antibiotic prophylaxis in inguinal hernia repair. Surg Gynecol Obstet 1992;175:569-570.
80
Morales R, Carmona A, Paga´n A. Utilidad de la profilaxis antibio´tica en la reduccio´n de la infeccio´n de herida en la reparacio´n de la hernia inguinal o crural mediante malla de prolipropileno[utility of antibiotic prophylaxis in reducing wound infection in inguinal or femoral hernia repair using polypropylene mesh]. Cir Esp 2000;67:51-59.
81
Otezia F, Ciga MA, Ortiz H. Profilaxis antibio´tica en la hernioplastia inguinal[antibiotic prophylaxis in inguinal hernioplasty]. Cir Esp 2004;75:69-71.
82
Aufenacker TJ, van Geldere D, van Mesdag T, et al. The role of antibiotic prophylaxis in prevention of wound infection after Lichtenstein open mesh hernia repair of primary inguinal hernia. A multicenter double-blind randomized controlled trial. Ann Surg 2004;240:955-961.
83
Celdra´n A, Frieyro O, dla Pinta JC, et al. The role of antibiotic prophylaxis on wound infection after mesh repair under local anesthesia on an ambulatory basis. Hernia 2004;8:20-22.
84
Badia JM, de la Torre R, Farre M, et al. Inadequate levels of metronidazole in subcutaneous fat after standard prophylaxis. Br J Surg 1995;82:479-482.
85
Terzi C. Antimicrobial prophylaxis in clean surgery with special focus on inguinal hernia repair with mesh. J Hosp Infect 2006;62:427-436.
