PROPHYLACTIC ANTIBIOTICS IN GYNECOLOGICAL SURGERY

Hysterectomies are contaminated procedures; surgical wound related sep sis ranges from 10 to 25 %. Several randomised controlled studies demo nstrated a significant benefit with prophylactic antibiotics. The stud y results were more controversial for abdominal hysterectomies. Ureido penicillins, cephamycins and other antibacterial agents active on Gram negative rods and anaerobes can be recommended as a preoperative flas h at anaesthesia induction, followed by a second injection whenever th e procedure duration exceeds 3 hours. In case of extended hysterectomy for cancer, broad spectrum antibiotic prophylaxis is usual; some rece nt studies demonstrated the efficacy of a short duration antibacterial agent use. Mastectomies are at low risk for postoperative infection. Antibacterial prophylaxis is common, especially in plastic surgery.