CHAPTER 6 Infection and surgery
Principles of wound management
Factors affecting wound healing
PREVENTION OF SURGICAL SITE INFECTION (Incorporating NICE guidelines 2008)
Antibiotics in surgery
Principles of antibiotic therapy
Selection of antibiotic
2. Based on signs, symptoms and clinical experience, a guess is made at the likely infecting organism.
3. The appropriate specimens are taken for microbiological examination, i.e. culture and sensitivity testing.
4. The most effective drug against the suspected organism is given in line with individual hospital guidelines. If doubt exists this is discussed with a microbiologist.
6. The antibiotic treatment is altered, if necessary, in response to laboratory reports of culture and sensitivities.
Prophylactic antibiotics
Indications for prophylactic antibiotics
• Implantation of foreign bodies, e.g. cardiac prosthetic valves, artificial joints, prosthetic vascular grafts
• Patients with pre-existing cardiac disease who are undergoing surgical procedures including dental procedures, e.g. patients with mitral valve disease as prophylaxis against infective endocarditis