Kılıçturgay, SadıkAktaş, Hikmet2023-01-302023-01-302017-06Sarkut, P. vd. (2017). ''Routine use of prophylactic antibiotics during laparoscopic cholecystectomy does not reduce the risk of surgical site infections''. Surgical Infections, 18(5), 603-609.1096-2964https://doi.org/10.1089/sur.2016.265https://www.liebertpub.com/doi/10.1089/sur.2016.2651557-8674http://hdl.handle.net/11452/30717Bu çalışma, 22-24 Kasım 2012 tarihleri arasında İstanbul[Türkiye]’da düzenlenen 16. Annual Meeting of the European-Society-of-Surgery (ESS)’da bildiri olarak sunulmuştur.Background: Laparoscopic cholecystectomy (LC) is the gold standard for the treatment of symptomatic gallbladder stones. As infections are rare in uncomplicated LC, it is widely accepted that prophylactic antibiotics need not be administered, and guidelines do not support routine antibiotic prophylaxis during elective LC. However, routine antibiotic prophylaxis for elective LC is still popular in many clinical settings. We investigated this situation in our department. Method: This randomized double-blind controlled study included 570 patients who underwent LC between March 2007 and February 2010. The exclusion criteria were antibiotic intake before surgery, steroid treatment, and the presence of pancreatitis, cholangitis, obstructive jaundice, cephalosporin allergy, or pregnancy. The patients were randomized into three groups. Group 1 (n = 193) received physiologic saline as placebo, Group 2 (n = 191) received a first-generation cephalosporin (cefazolin; 1 g), and Group 3 (n = 186) received a second-generation cephalosporin (cefuroksim aksetil; 750mg). Bile and epigastric and umbilical port tissue samples were harvested for culture. All patients were observed until the end of the fourth week after surgery. Patient age, sex, weight, American Society of Anesthesiologists (ASA) score, diabetes mellitus, smoking history, history of biliary colic in the past month, length of the hospital stay before the operation, operational findings (acute or chronic cholecystitis), operation duration, use of drainage, type of prophylaxis administered if any, culture results, surgical site infection (SSI) development, and time to SSI development along with associated treatments were evaluated. Results: There was no statistically significant difference between the groups with respect to any of the demographic and clinical features analyzed in this study. The SSI rate was 1.2% in total, and in Groups 1, 2, and 3, it was 1.5%, 1.04%, and 1.07%, respectively. There was no statistical difference regarding SSI among the groups (p = 1.00). Superficial SSI was observed in all groups, and in all patients, the site of infection was the entrance to the epigastric port through which the gallbladder had been removed. Conclusions: Surgical site infection is rare after LC, and antibiotic prophylaxis does not appear to affect the outcome significantly. Moreover, factors such as positive bile cultures, history of biliary attack, ASA score, diabetes, obesity, and smoking do not have any effect on SSI development. Thus, we conclude that antibiotic prophylaxis is not needed for elective LC.eninfo:eu-repo/semantics/closedAccessInfectious diseasesSurgeryLaparoscopic cholecystectomyProphylactic antibioticsSurgical site infectionPostoperative infectionGallbladder perforationPreventionEfficacyNeedAdolescentAdultAgedAged, 80 and overAnti-bacterial agentsAntibiotic prophylaxisBacteriaCholecystectomyLaparoscopicDouble-blind methodFemaleHumansMaleMiddle agedSurgical wound infectionYoung adultArticle0004042606000122-s2.0-8501969422860360918528375803Infectious diseasesSurgeryAntibiotic Prophylaxis; Surgical Infection; Anti-Bacterial AgentsAntibiotic agentCefazolinCefuroxime axetilPlaceboAntiinfective agentAcute cholecystitisAdultAgedBacterial growthBacterium isolateBileBiliary colicCholelithiasisChronic cholecystitisConference PaperControlled clinical trial;Controlled studyDiabetes mellitusDouble blind procedureDrug efficacyElective surgeryEnterococcus faecalisEnterococcus faeciumEscherichia coliFemaleGram negative bacteriumHumanHuman tissueInfection preventionInfection riskLaparoscopic cholecystectomyLength of stayMajor clinical studyMaleMedical historyObesityOperation durationPostoperative complicationPreoperative periodPriority journalProphylaxisRandomized controlled trialRare diseaseRisk assessmentRisk factorRisk reductionScoring systemSmokingStaphylococcus epidermidisStaphylococcus haemolyticusSurgical drainageSurgical infectionTissue cultureVery elderlyAdolescentAntibiotic prophylaxisBacteriumIsolation and purificationLaparoscopic cholecystectomyMicrobiologyMiddle agedStatistics and numerical dataSurgical wound infectionYoung adult