SA Orthopaedic Journal
versión On-line ISSN 2309-8309
KIGERA, JWM y GAKUO, LN. Is there a role for prolonged post-operative antibiotic use in primary total hip arthroplasty in the African setting?. SA orthop. j. [online]. 2013, vol.12, n.4, pp. 38-40. ISSN 2309-8309.
INTRODUCTION: The use of prophylactic antibiotics to reduce the risk of surgical site infection (SSI) is recommended for up to 24 hours post-operatively. Surgeons in Africa have been using antibiotics for prolonged periods of time because of perceived higher infection rates. We conducted a study to determine the incidence of early post-operative SSI and to determine if the use of antibiotics beyond 24 hours post-operatively resulted in any difference in this incidence after primary total hip arthroplasties. METHODS: A retrospective cohort study was conducted of all primary total hip arthroplasties done from 1998 to 2011. Patients had a prophylactic administered 30-60 minutes prior to surgical incision and the post-operative antibiotic regime was surgeon-dependent. The study was approved by the hospital Ethics Committee. RESULTS: The overall incidence of post-operative SSI was 1.5%. The duration of prophylactic antibiotic use among patients who were not treated for an SSI averaged 3.39 days (SD 7.496) and ranged from 0 to 65 days. There was no statistical difference in the incidence of post-operative SSI in patients who received prophylactic antibiotics for up to 24 hours (1.4%) and in patients who received antibiotics for longer than 24 hours (2%) (p=0.706). CONCLUSION: The risk of post-operative SSI after total hip arthroplasties is low. There is no evidence to support the use of prophylactic antibiotics for longer than 24 hours even in the African setting.
Palabras clave : post-operative; surgical site infection; arthroplasty; primary total hip.