Topical antibiotics in neurosurgery: a re-evaluation of the Malis technique.
We report the effect on the neurosurgical wound infection rate of a modification of the 'Malis' technique of antibiotic prophylaxis. In this a combination of antibiotics is given in the form of both parenteral administration and wound irrigation. A series of 1173 clean neurosurgical operations was compared with a historical control of 303 operations. Both treatment and control groups were operated on by the same surgeon, using similar surgical techniques. The control group received parenteral pre- and postoperative antibiotics (flucloxacillin and ampicillin). The treatment group (where the parenteral antibiotics used was cephradine) also received wound irrigation with a solution of gentamicin and flucloxacilin. The infection rate was 0.42% in the treatment group (five patients), in the control group it was 3.96% (12 patients). The difference was highly significant (p = 0.00006). We believe that the use of wound irrigation with antibiotics should receive further study.
Maurice-Williams
R S
RS
Department of Neurosurgery, Royal Free Hospital, London, UK.
Pollock
J
J
D000667:Ampicillin / Q000008:administration & dosage*; D019072:Antibiotic Prophylaxis / Q000379:methods; D002515:Cephradine / Q000008:administration & dosage; D004359:Drug Therapy, Combination / Q000008:administration & dosage*; D005436:Floxacillin / Q000008:administration & dosage*; D006801:Humans; D019635:Neurosurgical Procedures / Q000379:methods*; D013530:Surgical Wound Infection / Q000517:prevention & control*; D007507:Therapeutic Irrigation
D005436:Floxacillin; D000667:Ampicillin; D002515:Cephradine