DISCUSS SURGICAL PROPHYLAXIS IN SURGERY

ALADA A.A NOH, DALA

OUTLINE
INTRODUCTION STAGES OF PROPHYLAXIS PRE-OPERATIVE

INTRA-OPERATIVE POST-OPERATIVE CONCLUSION

INTRODUCTION

Defn; Refers to all science, art and technology that have been shown to improve outcome of the surgical event. Mirage of rituals taken by surgeons and associates Affected by geography and surgeons preference

PRE-OPERATIVE SURICAL PROPHYLAXIS

Starts from when diagnosis is established It could be in terms of General pre-op preparation, Specific treatment, Equipment/Instruments used.

General pre-op

Counseling/Psychology Hospital stay; infx, dvt Pre-op shower Op-list Fast Nursing care Shaving

Specific Treatment

Concurrent illness; DM, HBP, Anemia, Steroids, Malnutrition e.t.c Antibiotic prophylaxis Not a substitute Timing Route of Admin Choice of Agent Indications;Endogenous contaminant Exogenous contaminant

Host Immune Suppression Antitetanus Pre-op embolization Pre-op radiotherapy/chemotherapy Pre-op physiotherapy Peculiar op; colonic, obstructive jaundice DVT Prophylaxis

Equipment/Instruments

Theatre design Sterilization/Disinfectant Asepsis Skin drapes Skin preparation

INTRA-OP PROPHYLAXIS

Has got to do mainly with the surgical technique itself, includes Use of Non touch technique; involves touch instr with sterile forceps skin incision thru adhesive film dont touch business end of instru forceps for swabbing & tying ligatures & sutures

Protection from contamination Placement of sutures Clamping of bleeders Avoiding dead space/Drains Avoid prolonged surgery Prophylactic surgery; orchidopexy, colostomy Washing of wounds before closure

POST-OP PROPHYLAXIS

Wound care/ Dressings Drains Removal of sutures Nasogastric tube Early mobilization; DVT Antibiotics Adequate fluid Post-op monitoring; PCV, E/U

Physiotherapy; chest infx, orthopedic px

CONCLUSION
Good surgical prophylaxis is a fundamental part of good surgical practice. The goal of the surgeon in surgical prophylaxis is to ensure that untoward effect of surgery with its associated morbidity and mortality are minimized and maximum benefit is derived from the surgical event.