الفهرس 
HysterectomyOnly 14 pages are availabe for public view
 |  | from | 16 |  |  |
| | | from | 16 | | |
Abstract
Abdominal hysterectomy remains the predominant route utilized by the majority of gynecologists it’s associated with many of health problems after surgery as SSI especially in high risk groups as obese diabetic patients.
SSI compromise a major proportion of health care associated infections leading to increased morbidity as well as increased cost and length of hospital stay.
SSI was defined as infection that were related to operative procedure that occurred at or near the surgical incision (incisional or organ/space) within 30 days of an operative procedure or within one year if an implant was left in place.
SSI should include at least one of the following criteria: Purulent drainage from the incision and Organisms isolated from an aseptically obtained culture of fluid or tissue from the incision and at least one of the following signs or symptoms of infection: pain or tenderness, localized swelling, redness or heat.
Antibiotic prophylaxis for gynecologic surgery has become a widely accepted practice for reducing post-surgical complications such as wound infections, vaginal cuff cellulitis, endometritis, urinary tract infections (UTIs), and foreign-body infections.
Intravenous antibiotic prophylaxis given shortly before the start of surgery (at or less than 60 minutes of operation) are recommended by many hospitals and worldwide health organizations.
Single dose of antibiotic is adequate providing the half-life of the antibiotic covers the operation period. Additional doses are generally only needed for longer operations or when using agents with a short half-life.
Extending the dose of prophylactic antibiotic is controversial, the relation between extending the dose of prophylactic antibiotics and rate of SSI differ among many clinical trials.
In this study we assessed the role of extended dose of prophylactic antibiotic in preventing SSI after hysterectomy in diabetic obese women (high risk group).
This study was conducted at Ain shams maternity hospital in the period of 7 months on obese (BMI ≥30) diabetic patients who underwent simple abdominal hysterectomy.
Total number of studied patients was 82 patients who were randomized into 2 groups; group A (41 patients): took the standard dose of prophylactic antibiotic within 60 minutes of the operation (cefazoline IV), group B (41 patients): they took in addition to the standard dose of iv cefazoline an extended dose of prophylactic antibiotics (oral ofloxacin for 5 days every 12 hours) post operatively.
The data were collected at 2 levels: in the hospital stay and in the community setting to 30 days postoperatively.
The results show that there was a reduction in the percentage of SSI from 24.4% in group A to 7.4% in group B with a statistical difference between the two groups (p value=0.002).
The number of patients who needed secondary sutures in patients with SSI in group A was 6 (14.6%) while in group B the patients who needed secondary sutures in the patients with SSI was only one patient (2.5%) with a significant difference between the two groups (P value = 0.014).
Which show the efficacy of extended antibiotic prophylaxis in preventing SSI rates after surgery in high risk people for infection.