Cerrahide antibiyotik profilaksisi

Ciddi mortalite ve morbidite artışına neden olan cerrahi alan infeksiyonlarının gelişimini önlemeye yönelik uygulamalardan biri de antibiyotik profilaksisidir. Ancak, bilimsel temellere dayanmayan antibiyotik profilaksisi direnç gelişimi gibi birçok sorunları da yanında taşır. Antimikrobiyal profilaksi, temiz-kontamine ve kontamine ameliyatlarda tercih edilir, ancak protez uygulanan veya infekşiyon geliştiğinde ciddi morbidite ve mortalite artışına neden olan kalp cerrahisi, beyin cerrahisi ve vücuda yabancı implant uygulamalarında da temiz operasyonlar olmasına rağmen uygulanır. Seçilecek antibiyotiğin kontaminasyon riski en sık olan patojenlere etkili olması gerekir. Antibiyotiklerin genellikle tek doz ve intrav'enöz olarak anestezi indüksiyonu ile birlikte uygulanması tercih edilmektedir. Akılcı uygulanan antimikrobiyal profilaksi cerrahi alan infeksiyonlarını azaltmakla birlikte, hiçbir zaman iyi bir cerrahi tekniğin alternatifi olmadığı ve asepsi ve antisepsi kurallarının ihmalinden doğacak sonuçları engelleyemeyeceği unutulmamalıdır.

Anahtar Kelimeler:

Cerrahi, Antibiyotik proflaksisi, Cerrahi yara enfeksiyonu

Antimicrobial prophylaxis in surgery

One of the prevention methods of surgical site infections which increase seriously mortality and morbidity, is antimicrobial prophylaxis. If antimicrobial prophylaxis is not based on scientific evidences, it causes some problems such as antimicrobial resistance. Indications of antimicrobial prophylaxis are generally clean-contaminated or contaminated operations. Also, it is used in clean operations with foreign implants. The infections of heart and brain operations may cause hazardous complications, therefore, antibiotic prophylaxis should be used in these operations as well. The selected antibiotics for prophylaxis should cover the common pathogens, which cause contamination at the surgical wounds. Prophylactic antibiotic should be intravenously given at the induction of anaesthesia as single dose. Rational antimicrobial prophylaxis reduces surgical site infections, but it does not replace good surgical techniques and rules of asepsis and antisepsis.

Keywords:

Surgery, Antibiotic Prophylaxis, Surgical Wound Infection,

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