Role of Preoperative Prophylactic Antibiotics in Prevention of Surgical Site Infections in Clean Wounds

Abstract

Background: The role of routine antibiotic prophylaxis in clean elective surgery remains uncertain. This study evaluated its effectiveness in preventing surgical site infection (SSI).

Methods: This prospective comparative study included 50 patients undergoing clean elective surgery, with 25 patients each in the antibiotic and no-antibiotic groups. Patients were followed for 30 days for SSI and wound-related outcomes.

Results: Baseline characteristics were comparable between the groups. SSI occurred in 3 (12%) patients receiving prophylactic antibiotics and 4 (16%) patients without prophylaxis (p=0.69). Superficial SSI occurred in 8% and 12% of patients, respectively, while deep SSI occurred in 4% of each group. Mean wound-healing duration was 8.4 ± 2.1 versus 9.1 ± 2.5 days (p=0.21). Antibiotic prophylaxis was associated with lower odds of SSI (OR 0.62; 95% CI 0.10–3.93), but the association was not statistically significant (p=0.615).

Conclusion: Preoperative antibiotic prophylaxis did not significantly reduce SSI or improve wound-healing outcomes in clean elective surgery. A selective, risk-based approach to prophylactic antibiotic use may be appropriate.