Prophylaxis of minor febrile and major infectious morbidity following hysterectomy.
A retrospective analysis was conducted of 668 consecutive cases using T-tube suction drainage and/or prophylactic antibiotics as infection prophylaxis for hysterectomy. The data are analyzed for the incidence of minor febrile morbidity (temperature greater than 100.4 for 2 days) and for major infection (hospital stay more than 14 days, reoperation or readmission for the management of pelvic abscess or pelvic thrombophlebitis). The study also compares a minor febrile and major infection group with a noninfected group by measuring parameters of patient discomfort, medical staff effort, and financial costs. It is concluded that 1) minor febrile morbidity frequently follows abdominal (20--30%) and vaginal (30--50%) hysterectomy; 2) minor febrile morbidity has temporary but significant consequences in the form of increased patient discomfort, medical staff effort, and financial costs; 3) major infections are rare following abdominal hysterectomy (less than 0.5%) and uncommon following vaginal hysterectomy (1--4%); 4) suction drainage used alone, prophylactic antibiotics used alone, or a combination of suction drainage and antibiotic prophylaxis is each associated with a statistically significant reduction in the incidence of minor febrile morbidity following both abdominal and vaginal hysterectomy (P = less than 0.01); and 5) such infection prophylaxis may also reduce the incidence of major infection following vaginal hysterectomy.
D000038:Abscess / Q000209:etiology; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D005260:Female; D005334:Fever / Q000209:etiology / Q000517:prevention & control*; D006801:Humans; D007044:Hysterectomy; D007045:Hysterectomy, Vaginal; D017053:Infection Control; D007239:Infections / Q000209:etiology; D007902:Length of Stay; D010388:Pelvis; D011183:Postoperative Complications / Q000191:economics / Q000517:prevention & control*; D011292:Premedication; D012189:Retrospective Studies; D013396:Suction; D013924:Thrombophlebitis / Q000209:etiology
D000900:Anti-Bacterial Agents