Intraincisional Versus Intravenous Cefotaxime In Open Appendicectomies For Prevention Of Surgical Site Infections: A Randomised Controlled Trial

Abstract

Introduction Surgical site infection is one of the most common postoperative complications following abdominal surgeries. Whilst the use of prophylactic antibiotics has been shown to reduce postoperative wound infection, controversy remains as to the optimum route of administration and the duration of treatment. Objective To compare the efficacy of preoperative single dose of cefotaxime intraincisionally versus intravenously in preventing postoperative surgical site infections following open appendicectomies. Methodology Sixty cases diagnosed as uncomplicated appendicitis who consented for open appendicectomy in Jawaharlal Nehru Medical College and KLES Dr. Prabhakar Kore Hospital and MRC, Belgaum during the year 2012 were included in the study. Cases were randomized to 2 comparable groups of 30 patients each. Group A was given a single dose of Inj. Cefotaxime 1g intraincisionally and Group B was given a single dose of the same intravenously 30 minutes before the incision was made. Patients of both the groups were inspected on day 3, day 5 and day 7 following open appendicectomy and signs of surgical site infection if any, were recorded. Outcomes were tested for significance. Results All but one patient in Group A (96.7%) had an uneventful recovery 7 days following surgery whereas 4 out of 30 patients in Group B (13.3%) and a patient in Group A (3.3%) showed signs of postoperative surgical site infection (p >0.05) in the follow up period of seven days which prolonged their hospital stay. Conclusion The use of preoperative intraincisional single dose cefotaxime has a clinically considerable reduced risk of postoperative surgical site infection when compared to the conventional intravenous antibiotic prophylaxis in clean and clean contaminated abdominal surgeries like open appendicectomy.