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DISCUSS SURGICALPROPHYLAXIS IN

SURGERYALADA A.A

NOH, DALA

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OUTLINE

INTRODUCTION

STAGES OF PROPHYLAXIS

PRE-OPERATIVE

INTRA-OPERATIVE

POST-OPERATIVE

CONCLUSION

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INTRODUCTION

Defn; Refers to all science, art andtechnology that have been shown toimprove outcome of the surgical

event.

Mirage of rituals taken by surgeonsand associates

Affected by geography and surgeonspreference

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PRE-OPERATIVE SURICAL

PROPHYLAXIS

Starts from when diagnosis isestablished

It could be in terms ofGeneral pre-op preparation,Specific treatment,Equipment/Instruments used.

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General pre-op

Counseling/Psychology

Hospital stay; infx, dvt

Pre-op shower Op-list

Fast

Nursing care Shaving

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Specific Treatment

Concurrent illness; DM, HBP,Anemia, Steroids, Malnutrition e.t.c

Antibiotic prophylaxis

Not a substituteTimingRoute of AdminChoice of Agent

Indications;Endogenous contaminantExogenous contaminant

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Host Immune Suppression

Antitetanus

Pre-op embolization

Pre-op radiotherapy/chemotherapy

Pre-op physiotherapy Peculiar op; colonic, obstructivejaundice

DVT Prophylaxis

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Equipment/Instruments

Theatre design

Sterilization/Disinfectant

Asepsis Skin drapes

Skin preparation

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INTRA-OP PROPHYLAXIS

Has got to do mainly with thesurgical technique itself, includes

Use of Non touch technique; involvestouch instr with sterile forcepsskin incision thru adhesive filmdont touch business end of instru

forceps for swabbing & tyingligatures & sutures

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Protection from contamination

Placement of sutures

Clamping of bleeders

Avoiding dead space/Drains

Avoid prolonged surgery Prophylactic surgery; orchidopexy,

colostomy

Washing of wounds before closure

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POST-OP PROPHYLAXIS

Wound care/ Dressings

Drains

Removal of sutures

Nasogastric tube

Early mobilization; DVT

Antibiotics

Adequate fluid

Post-op monitoring; PCV, E/U

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Physiotherapy; chest infx, orthopedicpx

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CONCLUSION

Good surgical prophylaxis is afundamental part of good surgicalpractice. The goal of the surgeon in

surgical prophylaxis is to ensure thatuntoward effect of surgery with itsassociated morbidity and mortality areminimized and maximum benefit is

derived from the surgical event.