Abstract

"Surgical site infections (SSI) remain a significant contributor to postoperative morbidity and mortality. Antimicrobial prophylaxis to prevent SSI is one of the most widely accepted practices in surgery. Despite the evidence of effectiveness and the publication of guidelines for antimicrobial prophylaxis to prevent SSIs, prophylaxis use is often suboptimal. Optimal prophylaxis requires application in appropriate types of operations, selection of safe and effective antimicrobials, initial administration and redosing to maintain effective serum and tissue levels throughout the operation and discontinuation when the patient is no longer receiving a benefit and the antimicrobial agent should be bactericidal, safe, and inexpensive. Based on the published evidence, the infusion of the first antimicrobial dose should begin within 60 minutes before the surgical incision is made and prophylactic antimicrobials should be discontinued within 24 hours of the end of surgery. The initial antimicrobial dose should be adequate based on the patient's weight, adjusted dosing weight or body mass index. An additional dose of antimicrobial should be given intraoperatively if the operation is still continuing two half-lives after the initial dose. Antimicrobial prophylaxis is recommended at the time of many clean-contaminated and some clean operations. To reduce the risk of SSI, a systematic but realistic approach must be applied with the awareness that this risk is influenced by characteristics of the patient, operation, personnel and hospital."

• Keywords: Surgical wound infections, Antimicrobial prophylaxis, General surgery, Laparoscopic surgery, Urologic Surgical Procedures