Prophylactic topical cefamandole in radical hysterectomy.
From July 1, 1978 to June 30, 1984, 45 radical abdominal hysterectomies were performed by the authors at Tripler Army Medical Center. Management was uniform except for the use of prophylactic antibiotics. Three patterns of practice were identified: Group I, no antibiotics were used; Group II, intravenous (i.v.) antibiotics were given in the induction room and for less than 48 h post-surgery; Group III, prophylactic i.v. antibiotics were given and the surgical site was also irrigated with a cefamandole and saline solution. The three groups were found to be similar with regard to age, parity, weight-height index, pre- and postoperative hematocrit, pre-operative white blood cell count, operative and anesthesia times, estimated blood loss, and amount of blood transfused. Groups I and II had a higher surgical site infection rate (87.5% and 63.6%, respectively) than Group III (3.8%). The mean 10-day fever index in degree hours was 109 for Group I, 71 for Group II, and 30 for Group III (P less than 0.001). Irrigation of the surgical site with a cefamandole and saline solution in addition to i.v. antibiotics decreases the infectious morbidity of radical hysterectomy.
D000230:Adenocarcinoma / Q000601:surgery; D000287:Administration, Topical; D000328:Adult; D001424:Bacterial Infections / Q000517:prevention & control*; D002294:Carcinoma, Squamous Cell / Q000601:surgery; D002435:Cefamandole / Q000008:administration & dosage* / Q000627:therapeutic use; D002986:Clinical Trials as Topic; D004318:Doxycycline / Q000627:therapeutic use; D005260:Female; D006801:Humans; D007044:Hysterectomy; D008197:Lymph Node Excision; D008875:Middle Aged; D011183:Postoperative Complications / Q000517:prevention & control*; D011292:Premedication; D007507:Therapeutic Irrigation; D002583:Uterine Cervical Neoplasms / Q000601:surgery
D002435:Cefamandole; D004318:Doxycycline