Author/Editor		Rakovec, S
Title		Antibiotska profilaksa u digestivnoj kirurgiji
Type		članek
Source		In: Digestivna kirurgija: mehanički šav, antibiotska profilaksa. ,
Publication year		1989
Volume		str. 55-62
Language		cro
Abstract		Bacterial infections rank among the most frequent and dangerous postoperative complications. Various factors have been noted to contribute to their development: size and pathogenicity of the bacterial inoculum introduced into the qound during the procedure, alterations in host defence, and ambiental influences. The infection rate can be reduced with different measures, including antibiotic prevention. It is indicated in operations that carry a significant risk of postoperative infection. This relates not only to the occurence of septic complications, but also to its consequences. So in abdominal surgery prophylaxis is recommended always in colorectal operations. in appendicectomy and in procedures for obstruction of the small bowel it is indicated only in cases of gangrenous changes. In biliary tract surgery only where bactibilia is expected and in gastroduodenal surgery in sub-or an-acid conditions. The decicion for perioperative use of antibiotics ahould be based also on an cereful appraisal of host defence and predisposing factors. The antibiotics used must be effective against the major contaminatiing organisms. Proper dosage and timing is a key to effectiveness. it is essential that the drugs are given just in time: they must be at the site of contamination at the time the incision is made and thorughout the duration of the procedure. In cases of "pure" prophylaxis (infection is not present) postoperative administration is not necessary. The shortes possible course (mostly single dose) should be used. Continuing antibiotics after the procedure is not more effective, it may however be dangerous because of the possibile occurrence of the toxic and allergic side effects and of induction of resistant strains into the patient's and hospital flora. In numerous surgical procedures the view has prevailed that the incidence of infectious complications can be reduced by proper antibiotic prophilaxis. The costs of one or (at most) (abstract truncated at 2000 characters).
Descriptors		GASTROINTESTINAL DISEASES ANTIBIOTIC PROPHYLAXIS SURGICAL WOUND INFECTION APPENDECTOMY