Evaluation of extended antibiotic prophylaxis in patients undergoing indicated non-cosmetic panniculectomy at the time of gynecologic surgery.

Evaluation of extended antibiotic prophylaxis in patients undergoing indicated non-cosmetic panniculectomy at the time of gynecologic surgery.

Patibandla Jay R; Kufel Christina N; Hopkins Michael P

Journal of surgical oncology

2018

2018-05

BACKGROUND: Panniculectomy at time of gynecologic surgery is used to improve visualization and prevent major complications in morbidly obese patients. We examine the role of extended antibiotic prophylaxis in prevention of surgical site infections (SSI), specifically based on patient risk factors (hypertension, diabetes, smoking). METHODS: A prospective cohort study of all women who underwent panniculectomy at the time of gynecologic surgery from September 2014 to March 2016 at a university-affiliated hospital. The EAP cohort received standard antibiotics (cefazolin, 2 g) and continued oral antibiotic (doxycycline) for 10 days afterwards. Patients in this cohort were compared to historical controls from the same institution from 1990 to 2014. Specific attention was paid to the reduction of SSIs in patients with hypertension, diabetes, and a history of smoking. RESULTS: The mean age was 56.0 +/- 12.6 years, and mean body mass index 44.5 +/- 9.3 kg/m(2) (range 31-63.4 kg/m(2) ). The EAP cohort experienced fewer surgical-site infections overall, however these results were not significantly decreased from the historical controls, (13/56 [23.2%] vs 94/300 [31.3%]; P = 0.469). CONCLUSION: Though initially promising, extended antibiotic prophylaxis did not reduce surgical site infections in the obese women after indicated non-cosmetic panniculectomy at the time of gynecologic surgery.

Abdominal/*surgery; Antibiotic Prophylaxis/*methods; Body Mass Index; Female; Female/complications/*surgery; Follow-Up Studies; Genital Neoplasms; Gynecologic Surgical Procedures/*adverse effects; Humans; hysterectomy; Middle Aged; Morbid/complications/*surgery; Obesity; panniculectomy; Prognosis; prophylactic antibiotic; Prospective Studies; Risk Factors; Subcutaneous Fat; Surgical Wound Infection/*drug therapy/etiology; surgical-site infection

Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).

1337–1341

6

117