ANTIBIOTIC PROPHYLAXIS IN CLEAN AND CLEAN-CONTAMINATED SURGERY AND SURGICAL SITE INFECTION IN GENERAL SURGICAL WARDS IN IBRAHIM MALIK HOSPITAL AT KHARTOUM STATE
Israa Yousif Al- Khidir*, Abdalla El khawad, Habab EL Kheir, Sami Galal, Ahmed Abdulla Mohammed Osman, Asim Ahmed Elnour, Ahmed Mohammed Mohammed Nour
Background: The use of antimicrobial prophylaxis for surgical procedures is one of the measures employed to prevent the development of surgical site infections. Objectives: To study evaluate the impact of develop antibiotic prophylaxes protocol in clean and clean-contaminated surgery and surgical site infection in general surgical wards in Ibrahim Malik Hospital at Khartoum State. Methods: This is interventional, prospective case-control hospital based study assessed 226 clean or clean contaminated surgical procedures at Ibrahim Malik Hospital for adult patients. A protocol was established by the team consist of clinical pharmacist and two general surgeons. Study populations were divided into two major groups; 113 patients; (case group) underwent surgical procedures and supervised by surgeons who received guidelines for prevention of SSI and (control group) whose surgeons didn’t receive guidelines. Clean Surgical procedures included hernia repair and thyroidectomy, and two clean contaminated procedures (cholecystectomy and appendectomy). Patients’ data was obtained preoperatively and up to 14 days post-operatively through pre-designed questionnaire. Data was analyzed using (SPSS, vers. 23); both frequencies and chi squares were calculated. Results: The SSI was reported with rate of 35.4%; it was significantly less among case group when compared to control group (26.5% vs. 44.2% respectively, P = 0.003). The overall adherence was found significantly higher in case group when compared to control group (56.7% vs. 43.3% respectively, P < 0.0001). Adherence to duration of post-operative antibiotic was reported in 62.8% and 44.2% respectively, (P < 0.0001). Conclusion: The study concluded that, setting protocol for prevention of surgical site infection is significantly effective in reducing the risk of infection.
Keywords: Surgical prophylaxis, surgical site infection, prophylactic antibiotics, wound infection, antibiotics, Sudan.
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