Prevention Of Postoperative Wound Infections Research Articles

Perioperative Antibiotic Prophylaxis.

Postoperative surgical site infections (SSI) account for almost 25% of all nosocomial infections in Germany and are a source of increased morbidity and mortality. This review is based on pertinent publications retrieved by a selective search in PubMed and on national and international guidelines. The individual risk factors for SSI must be assessed before any surgical procedure. A body-mass index above 30 kg/m2 is associated with an unadjusted risk ratio of 1.35 [1.28; 1.41] for SSI, which rises to 3.29 [2.99; 3.62] if the patient is also immunosuppressed. The risk of SSI is also significantly higher with certain types of procedure. Perioperative antibiotic prophylaxis (PAP) is clearly indicated for operations that carry a high risk of SSI (e.g., colorectal surgery) and for those that involve the implantation of alloplastic material (e.g., hip endoprostheses). PAP can usually be administered with basic antibiotics such as cefazoline. The basic principles of PAP are that it should be given by the anesthesia team in the interval from 60 minutes preoperatively up to shortly before the incision, and that its administration should only be for a short period of time, usually as a single shot. Continuing PAP onward into the postoperative period leads to increased toxicity, bacterial superinfections, and antibiotic resistance. The evidence shows that perioperative antibiotic prophylaxis is a component of a bundle of measures that can help prevent SSI. Strict indications and adherence to the basic principles of PAP are essential for therapeutic success.

Hygienestandards im OP – führen sie nachhaltig zur Verbesserung der Qualität?

In Germany, nosocomial infections and postoperative wound infections are a significant burden for the healthcare system and the patients affected. A postoperative wound infection is often accompanied by a massive deterioration in the quality of the treatment success of surgical measures in terms of patient stress, the functional results and the cost-effectiveness of a treatment for the service provider. The aim of this article is to present the current hygiene requirements for the perioperative setting in a comprehensible manner and to explain them to everyone involved in the surgical procedure. First of all, the importance of hygienic measures is explained, as well as a brief overview of the development up to modern hygiene concepts of today. Then the current recommendations of the KRINKO (Commission for Hospital Hygiene and Infection Prevention at the Robert Koch Institute): "Prevention of postoperative wound infections, recommendation of the Commission for Hospital Hygiene and Infection Prevention (KRINKO) at the Robert Koch Institute" are presented. Hygienic work is a basic prerequisite for work in the surgical area, because convincing treatment results with good functional results cannot be achieved in many areas (e.g. modern endoprosthetics) without sufficient hygiene. The modern requirements for hygienic work are complex and affect all areas of the hospital. The best possible degree of process quality can only be guaranteed if all pillars of modern hygiene concepts are observed.

THE ROLE OF PROPHYLACTIC ANTIBIOTICS IN ZONE II AND ZONE V ACUTE FLEXOR TENDON INJURIES

Our study sought to establish the necessity of prolonged pre-operative antibiotic prophylaxis in patients presenting with zone II and zone V acute flexor tendon injuries (FTI). We hypothesized that a single dose of prophylactic antibiotic was adequate in prevention of post-operative wound infection in acute zone II and V FTI.This was a prospective study of 116 patients who presented with zone II and zone V acute FTI. The study included patients who were 18 years and older. Those with macroscopic contamination, immunocompromised, open fractures, bite injuries, and crush injuries were excluded. Patients were randomised into a group receiving a single dose of prophylactic antibiotic and another group receiving a continuous 8 hourly antibiotic doses until the day of surgery. Each group was subdivided into occupational and non-occupational injuries. Their post-operative wound outcomes were documented 10 – 14 days after surgery. The wound outcome was reported as no infection, superficial infection (treated with wound dressings), and deep infection (requiring surgical debridement).There was 0.9% rate of deep post-operative wound infections, which was a single zone V acute FTI case in a single dose prophylactic antibiotic group. There was a 7.8% superficial post-operative wound infection rate, which was mainly zone II acute FTI in both antibiotic groups. There was a strong association between zone II acute FTI and post-operative wound infection (p < 0.05). There was no association between (antibiotic dosage or place of injury) with post-operative wound infection (p > 0.05).There is no benefit in prescribing prolonged pre-operative antibiotic in patients with acute, simple lacerations to zone II and zone V FTI if there is no macroscopic wound contamination.

Influence of closed-incision negative-pressure wound therapy on the incidence of surgical site wound infection in patients undergoing spine surgery: A meta-analysis.

The present meta-analysis was conducted to comprehensively assess the impact of closed-incision negative-pressure wound therapy (ciNPWT) on the incidence of surgical site infections (SSIs) in patients undergoing spinal fusion surgery, thereby aiming to provide evidence-based support for the prevention of postoperative wound infections during spinal surgery. Relevant studies pertaining to the application of ciNPWT in spinal surgery were retrieved through searches of the PubMed, Embase, MEDLINE and Cochrane Library databases, spanning from their inception to May 2023. The literature screening and data extraction were performed by two researchers based on predefined inclusion and exclusion criteria, followed by a quality assessment of the included studies. Meta-analyses were performed using the odds ratios (ORs) and standardised mean differences (SMDs) as effect variables. RevMan 14.0 and STATA 17.0 were employed for meta-analysis of the extracted data. In total, eight articles involving 1198 patients, including 391 in the experimental group and 807 in the control group, were included. The meta-analysis results revealed that ciNPWT significantly reduced the incidence of SSIs in patients undergoing spinal fusion surgery (OR, 0.39; 95% CI: 0.22-0.67, p = 0.0007); however, it did not lead to a reduction in hospital stay duration (SMD: -0.48, 95% CI: -0.98 to 0.01, p = 0.06). Existing evidence suggests that ciNPWT has a positive impact on patients undergoing spinal fusion surgery, as it significantly reduces the incidence of postoperative surgical site wound infections; however, it does not result in a shorter hospital stay for patients.

Effectiveness of Oral Antibiotic Therapy in Prevention of Postoperative Wound Infection Requiring Surgical Washout In Spine Surgery

Surgical site infections (SSIs) after spine surgery are a significant cause of morbidity. Surgeons often prescribe oral antibiotics in the postoperative setting for infected-appearing wounds to prevent reoperation for infection; however, the efficacy of this practice has not been well studied. Neurosurgical spine patients with clinical concerns for SSI at the University of Pennsylvania were retrospectively studied from 2014 to 2018. Clinical predictors of 90-day reoperation for infection despite antibiotic treatment and variables that influenced antibiotic prescription were analyzed. Three hundred and ninety-two patients were included in the study. Preoperative albumin level, days elapsed to antibiotic prescription from index surgery, preoperative hemoglobin level, surgical location, gender, discharge disposition, and level of wound concern were significant predictors of reoperation for infection on bivariate analysis. Days elapsed to antibiotic prescription, surgical location, and level of wound concern remained significant after multivariable logistic regression. Variables that significantly predicted prescription of an antibiotic include length of stay, cerebrospinal fluid leak, race, and level of wound concern. Length of stay, race, and level of wound concern remained significant after multivariable analysis. Wound infection remains a challenging problem in spine surgery and it is reasonable to perform early reoperation in patients with high clinical concerns for infection, because bacterial isolates are often resistant to common oral antibiotics. Patients with wounds with low clinical concerns for infection may undergo a trial of oral antibiotics; however, duration of treatment should not be prolonged.

Current hygiene regulations in the operating theatre with special focus on constructional and functional measures

Der Beitrag gibt einen Überblick über wesentliche Neuerungen in der Hygiene, die sich aus der 2018 von der Kommission für Krankenhaushygiene und Infektionsprävention (KRINKO) publizierten Empfehlung „Prävention postoperativer Wundinfektionen“ ergeben. Diese fasst mehrere ältere Empfehlungen zusammen, ergänzt, aktualisiert und erweitert sie. Der Beitrag wirft einen besonderen Fokus auf die baulich-funktionalen Hygienevorschriften für den Operationssaal und bezieht die Stellung der Deutschen Gesetzlichen Unfallversicherung (DGUV) mit ein.

Risk factors for incisional hernia according to different wound sites after open hepatectomy using combinations of vertical and horizontal incisions: A multicenter cohort study.

Background: Although several risk factors for incisional hernia after hepatectomy have been reported, their relationship to different wound sites has not been investigated. Therefore, this study aimed to examine the risk factors for incisional hernia according to various wound sites after hepatectomy.Methods: Patients from the Osaka Liver Surgery Study Group who underwent open hepatectomy using combinations of vertical and horizontal incisions (J‐shaped incision, reversed L‐shaped incision, reversed T‐shaped incision, Mercedes incision) between January 2012 and December 2015 were included. Incisional hernia was defined as a hernia occurring within 3 y after surgery. Abdominal incisional hernia was classified into midline incisional hernia and transverse incisional hernia. The risk factors for each posthepatectomy incisional hernia type were identified.Results: A total of 1057 patients met the inclusion criteria. The overall posthepatectomy incisional hernia incidence rate was 5.9% (62 patients). In the multivariate analysis, the presence of diabetes mellitus and albumin levels <3.5 g/dL were identified as independent risk factors. Moreover, incidence rates of midline and transverse incisional hernias were 2.4% (25 patients), and 2.3% (24 patients), respectively. In multivariate analysis, the independent risk factor for transverse incisional hernia was the occurrence of superficial or deep incisional surgical site infection, and interrupted suturing for midline incisional hernia.Conclusions: Risk factors for incisional hernia after hepatectomy depend on the wound site. To prevent incisional hernia, running suture use might be better for midline wound closure. The prevention of postoperative wound infection is important for transverse wounds, under the presumption of preoperative nutrition and normoglycemia.

Assessment of Nurse’s Knowledge Concerning Prevention of Surgical Site Infection in Baghdad Teaching Hospitals

ABSTRACT: Background: Surgical site infections (SSIs) are defined as infections that occurs within 30 days of the operation or within one year if an implant is left in place after the procedure, Nurses play central role in the prevention of postoperative wound infection by Proper preparation of the patient before surgery and the application of aseptic technique to prevent contamination via bacteria from all sources during dressing, operation and throughout the healing process. For this reason, the researcher has conducted this study in order to evaluate Nurse’s Knowledge Concerning Prevention of Surgical Site Infection. Aims of the study: The main aim of the study is to asses nurses Needs Concerning Prevention of Surgical Site Infection and to provide quality of care, it is very important for nurses to have good knowledge towards prevention of SSI.

Effect of antibiotic prophylaxis in open inguinal hernioplasty (Lichtenstein hernia repair): a study in tertiary care center

Background: Inguinal hernia is one of the most common presenting surgical problems of abdomen and open inguinal hernioplasty (Lichtenstein hernia repair) is one of the most commonly performed general surgeries. Many time hernia repairs may lead to surgical site complication. There are many strong and effective antibiotics available for prophylaxis from these infections. Aims and objectives of the study were to compare rate of wound infection in post-operative cases among antibiotics prophylaxis group and placebo group.Methods: A prospective study was conducted in tertiary care centres with 200 patients enrolled in study. These patients were equally divided in both groups that is antibiotics arm and placebo group. The patients were in between age group of 18-70 years. The study duration was one and half years. Patients were included as per inclusion criteria. Data was entered and analysed using appropriate software.Results: There were total 200 patients recruited in the study with 100 patients in each group. Mean age of patients was 47.92±8.32 years in antibiotic group and 48.09±9.12 years in placebo group. All patients were males and most of th patients belong to rural area. A total of 12 patients develop surgical site infection out of which 6 patients were from antibiotics group and 8 patients from placebo group. Differences between these groups were not significant (0.426).Conclusions: This study showed that there was no clear acceptable benefit of antibiotics in prevention of post-operative wound infection in open inguinal hernioplasty (Lichtenstein hernia repair). Antibiotics administration did not reduce the incidence of wound infections in significant way.

Antibiotic prophylaxis for prevention of postoperative wound infection in adults undergoing open elective inguinal or femoral hernia repair.

Inguinal or femoral hernia is a tissue protrusion in the groin region and has a cumulative incidence of 27% in adult men and of 3% in adult women. As most hernias become symptomatic over time, groin hernia repair is one of the most frequently performed surgical procedures worldwide. This type of surgery is considered 'clean' surgery with wound infection rates expected to be lower than 5%. For clean surgical procedures, antibiotic prophylaxis is not generally recommended. However after the introduction of mesh-based hernia repair and the publication of studies that have high wound infection rates the debate as to whether antibiotic prophylaxis is required to prevent postoperative wound infections started again. To determine the effectiveness of antibiotic prophylaxis in reducing postoperative (superficial and deep) wound infections in elective open inguinal and femoral hernia repair. We searched several electronic databases: Cochrane Registry of Studies Online, MEDLINE Ovid, Embase Ovid, Scopus and Science Citation Index (search performed on 12 November 2019). We also searched two trial registers and the reference list of included studies. We included randomised controlled trials comparing any type of antibiotic prophylaxis versus placebo or no treatment for preventing postoperative wound infections in adults undergoing inguinal or femoral open hernia repair surgery (tissue repair and mesh repair). Two review authors independently selected studies, extracted data and assessed risk of bias. We separately analysed results for two different surgical methods (herniorrhaphy and hernioplasty). Several studies revealed infection rates that were higher than the expected 5% for clean surgery and we therefore divided studies into two subgroups: high infection risk environments (≥ 5% infection rate); and low infection risk environments (< 5% infection rate). We performed meta-analyses with random-effects models. We analysed three outcomes: superficial surgical site infections (SSSI); deep surgical site infections (DSSI); and all postoperative wound infections (SSSI + DSSI). In this review update we identified and included 10 new studies. In total, we included 27 studies with 8308 participants in this review. It is uncertain whether antibiotic prophylaxis as compared to placebo (or no treatment) prevents all types of postoperative wound infections after herniorrhaphy surgery (risk ratio (RR) 0.86, 95% confidence interval (CI) 0.56 to 1.33; 5 studies, 1865 participants; very low quality evidence). Subgroup analysis did not change these results. We could not perform meta-analyses for SSSI or DSSI as these outcomes were not reported separately. Twenty-two studies related to hernioplasty surgery (total of 6443 participants) and we analysed three outcomes: SSSI; DSSI; SSSI + DSSI. Within the low infection risk environment subgroup, antibiotic prophylaxis as compared to placebo probably makes little or no difference for the outcomes 'prevention of all wound infections' (RR 0.71, 95% CI 0.44 to 1.14; moderate-quality evidence) and 'prevention of SSSI' (RR 0.71, 95% CI 0.44 to 1.17, moderate-quality evidence). Within the high infection risk environment subgroup it is uncertain whether antibiotic prophylaxis reduces all types of wound infections (RR 0.58, 95% CI 0.43 to 0.77, very low quality evidence) or SSSI (RR 0.56, 95% CI 0.41 to 0.77, very low quality evidence). When combining participants from both subgroups, antibiotic prophylaxis as compared to placebo probably reduces the risk of all types of wound infections (RR 0.61, 95% CI 0.48 to 0.78) and SSSI (RR 0.60, 95% CI 0.46 to 0.78; moderate-quality evidence). Antibiotic prophylaxis as compared to placebo probably makes little or no difference in reducing the risk of postoperative DSSI (RR 0.65, 95% CI 0.26 to 1.65; moderate-quality evidence), both in a low infection risk environment (RR 0.67, 95% CI 0.11 to 4.13; moderate-quality evidence) and in the high infection risk environment (RR 0.64, 95% CI 0.22 to 1.89; low-quality evidence). Evidence of very low quality shows that it is uncertain whether antibiotic prophylaxis reduces the risk of postoperative wound infections after herniorrhaphy surgery. Evidence of moderate quality shows that antibiotic prophylaxis probably makes little or no difference in preventing wound infections (i.e. all wound infections, SSSI or DSSI) after hernioplasty surgery in a low infection risk environment. Evidence of low quality shows that antibiotic prophylaxis in a high-risk environment may reduce the risk of all wound infections and SSSI, while evidence of very low quality shows that it is uncertain whether antibiotic prophylaxis reduces DSSI after hernioplasty surgery.

Antimicrobial Therapy in Preventing Wound Infection Following Appendicectomy in Uncomplicated Appendicitis: A Comparative Study Between Single Dose And Multiple Doses In Adults

Objectives: To find out the efficacy of single dose antibiotic vs multiple dosesin preventing wound infection following appendicectomy for uncomplicated appendicitis.&#x0D; Methods: A prospective comparative study was conducted in the Department of Surgery, Chittagong Medical college Hospital from January'2009 to June'2009. 100 patients with uncomplicated appendicitis who underwent appendicectomy during that period were included in this study. Among them 50 cases were included in study group ·(SG) who were given only single dose of combination drugs ( lnj. Cefuroxime + lnj. Metronidazole).ln rest of the 50 cases (CG), antibiotics were continued for 7 days postoperatively.&#x0D; Result: Maximum incidence of acute appendicitis was in the 2nd and 3rd decade of life with male preponderance .Rate of wound infection in the study group and control group was 4% and 2% respectively which was not statistically significant .The duration of antibiotic therapy had no significant effect on the length of hospital stay between the two groups ; 2.48 days vs 2.9 days [mean + s.d. 69.6 # 16.8 hours ] in the study and control group respectively, though treatment cost was higher in control group in comparison to the study group .&#x0D; Conclusion: Single dose of preoperative antibiotics is adequate for prevention of postoperative wound infection following appendicectomy for uncomplicated appendicitis.&#x0D; Journal of Surgical Sciences (2015) Vol. 19 (1) : 17-20

The role of antibiotic prophylaxis in the prevention of surgical-site infection after hernioplasty in Menoufia University Hospital

Objective The aim of this paper was to evaluate the effectiveness of prophylactic antibiotics in the prevention of postoperative wound infection after Lichtenstein open mesh inguinal hernia repair. Background Inguinal hernia is one of the most common conditions encountered in clinical practice. Mesh repair is becoming the most popular technique for the repair of inguinal hernia. A surgical-site infection is defined as an infection that occurs at or near a surgical incision within 30 days of the procedure or within three months if an implant is left in place. The decision of perioperative antibiotic prophylaxis is made according to a number of risk factors, in particular, in aseptic interventions. The use of antibiotic prophylaxis for clean surgical procedures such as inguinal hernia surgery is controversial. Patients and methods Between November 2014 and November 2015, this prospective randomized-controlled study included 40 patients who presented with inguinal hernia. Patients were randomized into two groups. Group A was administered an antibiotic at the induction of anesthesia. Group B was administered sterile normal saline. After Lichtenstein inguinal hernioplasty, patients were followed up at 7–10 and 28–35 days to assess surgical-site infection. Results Of a total of 40 patients (37 men and three women), 20 in each group, one (2.5%) patient developed wound infection in group A and two (5%) patients developed wound infection in group B. Conclusion There is no benefit of an intravenous single-dose antibiotic prophylaxis in the prevention of wound infection following Lichtenstein inguinal hernioplasty in patients with no other co-morbid conditions.

A Randomized Controlled Study of Single-Dose Antibiotic Prophylaxis for Clean Surgeries

Objectives The aims of this study were to establish the use of single-dose prophylactic intravenous antibiotics in the prevention of postoperative wound infection following clean surgeries in a government setup in India and to assess the efficacy of single-dose prophylactic ceftriaxone in preventing surgical site infection following clean surgeries by a prospective randomized trial. Methods A prospective study was done on patients in the Department of General Surgery in Karnataka Institute of Medical Sciences, Hubli, Karnataka, India, from January 2011 to December 2014. A total of 822 patients were divided into 2 groups. The first group (A), consisting of 406 patients, received a single-dose antibiotic prophylaxis, and the second group (B), consisting of 416 patients, received 3 days or more of postoperative doses of antibiotic therapy. Only clean procedures are included, and results were compared. Results In the first group (A), the rate of infection was 4 of 406. In the second group (B), the rate of infection was 6 of 416. Overall wound infection rate was 0.95%; wound infection rate after administration of single-dose preoperative antibiotic was 0.96%, and in the routine postoperative group, it was 0.94% (P = 0.9). Conclusions This study concludes that single-dose preoperative antibiotic alone is as effective as the use of empiric antibiotics given for 3 days or more in clean surgeries. It will facilitate in decreasing superinfections among and resistance to bacterial strains, health care costs, and morbidity secondary to antibiotic administration (eg, drug toxicity, antibiotic-related diarrhea) in a developing country such as India.

Efficacy of Diluted Betadine Solution Irrigation in the Prevention of Postoperative Infection of Spinal Surgery

Background: Deep wound infection is a serious complication of spinal surgery that can jeopardize patient outcomes and increase costs. Povidone iodine is a widely used antiseptic with bactericidal activity against a wide spectrum of pathogens, including methicillin-resistant Staphylococcus aureus.Objectives: To evaluate the efficacy of diluted betadine irrigation of spinal surgical wounds in prevention of postoperative wound infection. Patients and Methods: One hundred patients of both sex aged 25-65 years old were enrolled in this prospective study. The patients were randomized in to two equal groups. In group 1 (50 patients), surgical wounds were irrigated with diluted betadine solution (3.5% betadine) before wound closure. In group 2(50 patients), the wounds were not irrigated and serve as a control. Otherwise, perioperative management was the same for both groups.Results: Mean length of follow-up was 24 months in both groups (range, 12–24 months). No wound infection occurred in group 1. One superficial infection (2%) and six deep infections (12%) occurred in group 2.Conclusions: Diluted Betadine effectively prevents spinal surgery wound infection therefore it is recommended to use this simple and inexpensive antiseptic substance following spinal surgery.

Comparative Efficacy of Amoxicillin/Clavulanic Acid and Levofloxacin in the Reduction of Postsurgical Sequelae After Third Molar Surgery: A Randomized, Double-Blind, Clinical Trial in a Nigerian University Teaching Hospital.

Background:The most common sequelae after surgical removal of mandibular third molar are pain, trismus, swelling, and dysphagia. However, these symptoms can also signal the onset of surgical site infection and alveoli osteitis. The aim of this study was to evaluate the efficacy of prophylactic amoxicillin/clavulanic acid and levofloxacin and preemptive therapy of amoxicillin/clavulanic acid in the reduction of postinflammatory complications, surgical site infection, and alveolar osteitis following the third molar surgery.Patients and Methods:A total of 135 patients were randomized into three equal groups: Group A (preemptive therapy of amoxicillin/clavulanic acid) with preoperative dose of 875/125 mg amoxicillin/clavulanic acid followed by 500/125 mg amoxicillin/clavulanic acid 12 hourly for 5 days, Group B (amoxicillin/clavulanic acid prophylaxis) with a single preoperative dose of amoxicillin/clavulanic acid 875/125 mg tablets, and Group C (levofloxacin prophylaxis) with a single preoperative dose of levofloxacin 1000 mg tablets. All patients had ostectomy using surgical handpiece and burs and received same analgesics (tabs ibuprofen 400 mg 8 hourly for 3 days).Results:No case of surgical site infection or alveoli osteitis was recorded in the study groups. There were no statistically significant differences between the treatment groups with regard to pain, mouth opening, postoperative facial dimension, and body temperature.Conclusion:Amoxicillin/clavulanic acid as a single preoperative bolus should be adequate for the prevention of postoperative wound infection and alveoli osteitis following the third molar extraction as there is no need for an extension of the antibiotic. Moreover, levofloxacin can be utilized as prophylaxis in patients undergoing mandibular third molar extraction if such patients are allergic to penicillins.

Clinical efficacies of full-thickness suturing plus subcutaneous negative pressure drainage in the prevention of postoperative abdominal wound infection: a report of 68 cases

From April 2011 to October 2013, 68 patients scheduled for complex hepatobiliary and pancreatic surgery underwent full-thickness suturing of abdominal incision with subcutaneous negative pressure drainage. There was no such complications as wound dehiscence or sinus formation. Except for 2 cases of wound infection, primary healing was achieved. Two infected cases were followed up for 1 year and there was incisional hernia. The full-thickness suturing of abdominal incision plus subcutaneous negative pressure drainage could prevent postoperative wound infection and promote wound healing. And this simple and practical approach is worthy of wider clinical application. Key words: Surgical wound infection; Negative-pressure wound therapy

Prevention of postoperative wound infections by covering the surgical field with iodine-impregnated incision drape (Ioban 2).

The literature is used to analyse the significance of the use of iodine-impregnated incision drape (Ioban® 2) for the prevention of postoperative wound infections (SSI). The drape has a microbiocidal effect in vitro. Consequently an antiseptic effect also occurs under the incision drape when it is applied to the skin; at the same time, bacterial wound contamination is reduced. Overall, based on the efficacy strength of the antiseptic incision drape, a reduction of the SSI rate can, however, be confirmed only with a large sample size. A meta analysis which evaluated four prospective studies and one retrospective study was able to provide significant confirmation of a reduction in the SSI rate. There are no limitations in terms of the biocompatibility of the iodine-impregnated incision drape.

Methodological issues regarding safety evaluation in randomized controlled trials of the effectiveness of antibiotic prophylaxis for the prevention of post-operative wound infection: systematic review

Methodological issues regarding safety evaluation in randomized controlled trials of the effectiveness of antibiotic prophylaxis for the prevention of post-operative wound infection: systematic review

Prevention of postoperative wound infections – what would be worthwhile, and what might be done?

Prevention of postoperative wound infections – what would be worthwhile, and what might be done?

Prevention of postoperative wound infections – what would be worthwhile, and what might be done?

Prevention of postoperative wound infections – what would be worthwhile, and what might be done?