• Title/Summary/Keyword: prophylactic

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Comparing the Postoperative Complications, Hospitalization Days and Treatment Expenses Depending on the Administration of Postoperative Prophylactic Antibiotics to Hysterectomy (자궁적출술 후 예방적 항생제 사용 여부별 수술 후 합병증, 재원기간 및 치료비 비교)

  • Jung, Mi Young;Park, Kyung-Yeon
    • Women's Health Nursing
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    • v.23 no.1
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    • pp.42-51
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    • 2017
  • Purpose: This study was conducted to compare postoperative complications, hospitalization days and treatment expenses to postoperative prophylactic antibiotics administrated to hysterectomy or not. Methods: A retrospective survey study was performed with 128 cases in which elective hysterectomy had undergone. They were divided into two groups by identifying whether postoperative prophylactic antibiotics was administered for hysterectomy: a) one group who received postoperative prophylactic antibiotics and; b) those who did not. Data were collected using the electric medical record at a hospital and analyzed by SPSS 23.0 for $x^2$ test, t-test and ANCOVA. Results:Postoperative complications including wound infection (p=1.000), pneumonia (p=.496), hematoma (p=.530), and pneumoperitoneum (p=.496) showed no significant differences between two groups. Hospitalization days for the prophylactic antibioticsadministrated group were significantly longer than the non-administered for prophylactic antibiotics (p=.004). The treatment expenses of the prophylactic antibiotics-administrated group were significantly higher than those of the non-administered prophylactic antibiotics (F=4.31, p=.040). Conclusion: These results can be provided for the evidence of administrating postoperative prophylactic antibiotics to hysterectomy. Additionally, it can contribute to decreasing the medication errors caused by infrequently administrating postoperative prophylactic antibiotics as well as to lessening likelihood of infection of intravenous injection site.

Perceptions of Prophylactic Mastectomy in Korea

  • Yoon, Han Young;Shim, Jeong Su;Lee, Jong Won
    • Archives of Plastic Surgery
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    • v.43 no.1
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    • pp.53-58
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    • 2016
  • Background Increasingly, prophylactic mastectomy has been evaluated as a treatment of breast cancer. Hereditary breast cancer now accounts for approximately 5%-10% of all cases of breast cancer, meaning that the widespread implementation of prophylactic mastectomy may significantly reduce the occurrence of breast cancer. However, prophylactic mastectomy is rarely performed in Korea. Therefore, in this study, we assessed Koreans' attitudes toward and awareness of preventive mastectomy. Methods This was a prospective study of a cohort of patients attending outpatient clinics and their relatives. Data were collected using self-administered questionnaires assessing sex, age, educational level, knowledge of breast cancer, understanding of prophylactic mastectomy, attitudes toward prophylactic mastectomy, and reasons for choosing prophylactic mastectomy. Results Sixty-five patients were included. Most patients (36.9%) were between 40 and 49 years of age and 58.4% were college graduates. Only six respondents (9%) understood prophylactic mastectomy, and 17 respondents (27%) stated that they would agree to undergo prophylactic mastectomy if necessary. Reasons given for refusing prophylactic mastectomy included aesthetic concerns (38%), the perception that it would not cure the disease (26%), possible surgical complications (24%), and financial cost (6%). Conclusions In this study, most of the respondents showed a poor knowledge of prophylactic mastectomy. Ultimately, it will be necessary to establish medical guidelines for patients with a high risk of breast cancer, with the objective of providing accurate information and proper treatment at hospitals.

Feasibility of No Prophylactic Antibiotics Use in Patients Undergoing Total Laparoscopic Distal Gastrectomy for Gastric Carcinoma: a Propensity Score-Matched Case-Control Study

  • Na, Yongmin;Kang, Ji Hoon;Jung, Mi Ran;Ryu, Seong Yeob;Jeong, Oh
    • Journal of Gastric Cancer
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    • v.19 no.4
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    • pp.451-459
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    • 2019
  • Purpose: Laparoscopic surgery is associated with lower surgical site infection (SSI) rates due to minimal skin incision and non-exposure of visceral organs. Most previous studies have analyzed the efficacy of prophylactic antibiotic use in open surgery. Here, we investigated the feasibility of total laparoscopic distal gastrectomy (TLDG) for gastric carcinoma without prophylactic antibiotic use. Materials and Methods: Seventy-one patients who underwent TLDG without prophylactic antibiotic use were 1:1 propensity score matched with 393 patients who underwent TLDG with antibiotic prophylaxis. The short-term surgical outcomes, including SSI rates, were compared between the groups. Results: After matching, 65 patients were selected in each group. The baseline clinicopathological characteristics were well balanced in the matched sample. In the matched group, there was no significant increase in postoperative morbidity in the non-prophylactic group compared with the prophylactic group (18.5% vs. 15.4%, P=0.640), and there were no grade 3≤ complications (1.4% vs. 0%, respectively; P=1.000). The SSI rates in the non-prophylactic and prophylactic groups were 3.1% and 1.5%, respectively (P=0.559). The time to gas passage, diet initiation, and mean hospital stay were not significantly different between the 2 groups. The SSI rate did not increase in the non-prophylactic group in the different subgroups based on different clinicopathological characteristics. Conclusions: Postoperative morbidity, including SSI rates, did not significantly increase in patients undergoing TLDG without prophylactic antibiotic use. A large prospective randomized trial is warranted to reappraise the efficacy of prophylactic antibiotic use in patients undergoing TLDG.

Is Prophylactic Central Node Dissection Omissible? (갑상선유두상암에서 예방적 중심경부림프절제술은 생략할 수 있는가?)

  • Shin, Sung-Chan;Lee, Byung-Joo
    • Korean Journal of Head & Neck Oncology
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    • v.34 no.1
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    • pp.1-7
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    • 2018
  • Papillary thyroid carcinoma has a good prognosis, but the frequency of locoregional lymph node metastasis is high and is known to occur stepwise fashion. Prophylactic central node dissection in papillary thyroid carcinoma is widely performed from the past. But, the pros and cons of the prophylactic central node dissection has been ongoing for a long time. In the American Thyroid Association management guideline for thyroid nodules and differentiated thyroid cancer, which is the most widely used, recommendations about prophylactic central node dissection has been changed in past ten years. In recent systematic review and meta-analysis, prophylactic central node dissection increases the rate of transient hypocalcemia and recurrent laryngeal nerve injury, but there is no difference in the frequency of permanent hypocalcemia or recurrent laryngeal nerve injury. Prophylactic central node dissection has not been shown to improve patient survival, but recurrence has been reported to decrease. According to a questionnaire survey of the members of Korean Scociety of Thyroid-Head and Neck Surgery, Korean doctors tend to perform the prophylactic central node dissection more aggressively than other countries. The reason for this is that Korea has a large number of thyroid surgeries and therefore surgeons are more experienced than other countries.

Prophylactic effect of topical betaxolol and dorzolamide on the fellow eye in unilateral canine primary angle closure glaucoma: 60 cases (2016.1-2021.5)

  • Ahn, Junyeong;Kang, Seonmi;Shim, Jaeho;Jeong, Youngseok;Lee, Songhui;Lee, Eunji;Seo, Kangmoon
    • Korean Journal of Veterinary Research
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    • v.62 no.3
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    • pp.26.1-26.7
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    • 2022
  • This study was aimed to evaluate the prophylactic anti-glaucoma effect of topical 5% betaxolol (BTX) and 2% dorzolamide (DRZ) on the second eye in dogs with unilateral primary angle closure glaucoma (PACG). Medical records of 60 dogs with unilateral PACG who received prophylactic anti-glaucoma eyedrops in the second eye, from 2016 to 2021, were reviewed. The prophylactic effects of BTX were maintained on 28/60 (46.7%) eyes until last visit and BTX failure was observed on median 510 (range, 53-1,927) days in 32/60 (53.3%) eyes. After DRZ instillation in BTX failure eyes, the prophylactic effects were extended at median 610 (range, 157-2,270) days in 21/32 (65.6%) eyes. DRZ failure eyes (17/21, 81.0%) eyes required chemical ablation or surgical intervention due to uncontrolled intraocular pressure. The duration of prophylactic effects was decreased with aging (R2 = 0.334, p = 0.006). The predominant breeds were Shih-Tzu (41.9%) and American Cocker Spaniel (30.6%) with no significant differences in survival curves (p = 0.210). The average prophylactic effects of BTX persisted more than 1.5 year and could be selected the first prophylactic eye drop in unilateral PACG. Also, early surgical intervention should be considered in prophylactic medications failure cases.

Antibiotic Prophylaxis' Effect on Enophthalmos in Orbital Floor Fracture with Chronic Maxillary Sinusitis (상악동염이 있는 안와 하벽 골절에서 예방적 항생제의 중요성)

  • Sung, Hyoung Woo;Kim, Jin Woo;Shin, Han Kyung;Jung, Jae Hak;Kim, Young Hwan;Sun, Hook
    • Archives of Craniofacial Surgery
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    • v.9 no.2
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    • pp.67-71
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    • 2008
  • Purpose: Orbital floor fracture has open wound to maxillary sinus and if the patient has chronic maxillary sinusitis, it may be have more risk of infection, complications. The purpose of this comparative study is to be the effectiveness of prophylactic antibiotics in orbital floor fracture with chronic maxillary sinusitis. Methods: We studied 20 patients who diagnosed as orbital floor fracture with chronic maxillary sinusitis from march, 2005 to may, 2006. Among them 16 were male, 4 were female and age was ranged from 15 to 68, average was 42. A day before operation, Prophylactic antibiotics were used to 10 patients. Prophylactic antibiotics were not used to 10 patients. We defined control group as prophylactic antibiotics injection group a day before operation. After surgery, we confined use of same antibiotic for 7 days in both group. After 6 month from surgery, we compare the degree of enophthalmos from healthy side to legion side with hertel exopthalmometry(Inami, Japan) in control group and non-prophylactic antibiotics injection group. Results: In control group, comparison of discrepancy between enophthalmic eyeball and normal eyeball with Hertel exophthalmometer was 1.1 mm and non-prophylactic antibiotics injection group was 2.1 mm. In independent sample t-test, control group was showed statistically significant difference with non-prophylactic antibiotics injection group(p=0.007). Conclusions: In orbital floor fracture with chronic maxillary sinusitis, bacteria in maxillary sinus can increase post-operative complication by infecting infraorbital soft tissue, and it is thought to be antibiotic prophylaxis is play a role in decrease in degree of enophthalmos. We feel the need to further study of prophylactic antibiotics in orbital floor fracture with chronic maxillary sinusitis.

Appropriateness of Ampicillin/sulbactam as Prophylactic Antibiotics in Liver Transplantation (간이식 수술 전후 예방적 항생제 ampicillin/sulbactam의 적절성 평가)

  • Kim, Young-Ae;Cho, Yoon-Sook;Kim, Hyang-Sook;Lee, Hye-Sook;Yi, Nam-Joon;Lee, Kwang-Woong;Suh, Kyung-Suk;Lee, Ju-Yeun
    • Korean Journal of Clinical Pharmacy
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    • v.22 no.4
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    • pp.324-329
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    • 2012
  • The most common complication after liver transplantation (LT) is bacterial infection. The incidence of surgical site infections (SSIs) after LT was variable from 8.8%~37%. However, there has been no confirmed guideline in use of prophylactic antibiotics after LT. Ampicillin/sulbactam has been used as main prophylactic antibiotics after LT in Seoul National University Hospital (SNUH) according to the center protocol. The purpose of this study was to determine the incidence and risk factors for SSI after LT and to evaluate the appropriateness of prophylactic antibiotics. A total of 211 patients who underwent LT between July 2008 and June 2010 at SUNH were included. During study period, ampicillin/sulbactam was selected as prophylactic antibiotics in 140 patients (66.4%). A total of 43 patients (20.4%) developed infections and the incidence of SSI was noted in 28 patients (13.2%); 10.0% in ampicillin/sulbactam group and 19.4% in other antibiotics (p=0.049). The most common pathogen of SSI was MRSA (13 episodes, 49.4%). In multivariate analysis, choledochojejunostomy (OR: 7.0; 95% CI, 2.4-20.0) and lower serum albumin (OR: 3.7; 95% CI, 1.1-12.9) were found to be risk factors of SSIs. In conclusion, the incidence of SSIs after LT in this population was similar to those in other studies. Therefore, the prophylactic antibiotics protocol in LT at SNUH seems to be appropriate.

The effectiveness of prophylactic ipsilateral central neck dissection in selected patients who underwent total thyroidectomy for clinically node-negative unilateral papillary thyroid carcinoma

  • Kang, Jin Gu;Kim, Young Ah;Choi, Jung Eun;Lee, Soo Jung;Kang, Su Hwan
    • Journal of Yeungnam Medical Science
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    • v.37 no.3
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    • pp.202-209
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    • 2020
  • Background: Prophylactic central neck dissection (CND) in clinically node-negative (cN0) papillary thyroid carcinoma (PTC) remains controversial. The purpose of this study was to evaluate the benefits of prophylactic ipsilateral CND compared with bilateral CND in total thyroidectomy for cN0 unilateral PTC. Methods: We retrospectively enrolled 174 patients who underwent total thyroidectomies with prophylactic CND for cN0 unilateral PTC between January 2009 and May 2010. The prophylactic CND patients were divided into group 1, the ipsilateral CND group (n=74), and group 2, the bilateral CND group (n=100). The incidence of central lymph node metastasis (CLNM) and postoperative complications, such as hypoparathyroidism, recurrent laryngeal nerve injury, and recurrence were assessed. Results: CLNM was found in 22 (29.8%) in group 1 and 69 (69%) in group 2. The incidence of postoperative severe hypocalcemia less than 7.0 was also significantly different (six patients [8.1%] in group 1 and 23 [23%] in group 2; p=0.009). Permanent hypoparathyroidism was significantly more frequent in group 2 (4.1% vs. 19%; p=0.005). However, the incidence of transient hypoparathyroidism, recurrence, and recurrent laryngeal nerve injury was not significantly different. Conclusion: Prophylactic ipsilateral CND has advantage not only to reduce incidence of some complications but also to have similar recurrence rate compared with bilateral CND. We suggest that prophylactic ipsilateral CND may be safe and effective for selected patients undergoing total thyroidectomy for cN0 unilateral PTC.

Comparative observational study of aminophylline with prophylactic and therapeutic uses for clinical outcomes in preterm infants

  • Bae, Mi Hye;Lee, Na Rae;Han, Young Mi;Byun, Shin Yun;Park, Kyung Hee
    • Kosin Medical Journal
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    • v.33 no.3
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    • pp.380-385
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    • 2018
  • Objectives: Aminophylline has been used for prevention or treatment of apnea in preterm infants with idiopathic apnea of prematurity. The aim of this study was to assess the clinical usefulness of prophylactic in comparison with therapeutic aminophylline therapy. Methods: This retrospective observational study included infants born with a birth weight of < 2,500 g or at < 36 weeks of gestation. Infants born between August 2013 and July 2014 who received aminophylline therapy within 24 hr after birth were assigned to the prophylactic group, while infants born between August 2014 and July 2015 who received aminophylline therapy after obvious apnea were assigned to the therapeutic group. We compared clinical characteristics, including days of ventilator and oxygen therapy and bronchopulmonary dysplasia (BPD) between both groups. Results: Sixty-four patients and 25 infants were identified in the prophylactic and therapeutic groups, respectively. The mean gestational age and birth weight were $32.57{\pm}1.96weeks$ and $1765{\pm}205g$, respectively, in the prophylactic group and $32.46{\pm}1.82weeks$ and $1770{\pm}250g$, respectively, in the therapeutic group. No significant differences in clinical characteristics were found between the two groups. Similar clinical outcomes, including days of ventilator and oxygen therapy, intraventricular hemorrhage (IVH), periventricular leukomalacia, and BPD, were observed between the two groups. Conclusions: The present study showed that the prophylactic use of aminophylline does not improve the clinical outcomes, including BPD, IVH, and ventilator dependency as compared with therapeutic use. In other words, routine prophylactic use of aminophylline is unnecessary.

Effects of various prophylactic procedures on titanium surfaces and biofilm formation

  • Di Salle, Anna;Spagnuolo, Gianrico;Conte, Raffaele;Procino, Alfredo;Peluso, Gianfranco;Rengo, Carlo
    • Journal of Periodontal and Implant Science
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    • v.48 no.6
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    • pp.373-382
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    • 2018
  • Purpose: The aim of this study was to evaluate the effects of various prophylactic treatments of titanium implants on bacterial biofilm formation, correlating surface modifications with the biofilms produced by Pseudomonas aeruginosa PAO1, Staphylococcus aureus, and bacteria isolated from saliva. Methods: Pure titanium disks were treated with various prophylactic procedures, and atomic force microscopy (AFM) was used to determine the degree to which surface roughness was modified. To evaluate antibiofilm activity, we used P. aeruginosa PAO1, S. aureus, and saliva-isolated Streptococcus spp., Bacteroides fragilis, and Staphylococcus epidermidis. Results: AFM showed that the surface roughness increased after using the air-polishing device and ultrasonic scaler, while a significant reduction was observed after using a curette or polishing with Detartrine ZTM (DZ) abrasive paste. In addition, we only observed a significant (P<0.01) reduction in biofilm formation on the DZ-treated implant surfaces. Conclusion: In this study, both AFM and antibiofilm analyses indicated that using DZ abrasive paste could be considered as the prophylactic procedure of choice for managing peri-implant lesions and for therapy-resistant cases of periodontitis.