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Antimicrobial Prophylaxis for the Prevention of Surgical Site Infection After Thyroid and Parathyroid Surgery: A Prospective Randomized Trial

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Abstract

Background and Objective

The effectiveness of antimicrobial prophylaxis (AMP) in the prevention of surgical site infection (SSI) following thyroid and parathyroid surgery remains uncertain. The objective of this prospective randomized controlled trial (Ito-RCT1) was to assess the effectiveness of AMP in clean neck surgery performed to treat thyroid and parathyroid disease.

Methods

Participants comprised patients scheduled for clean neck surgery for thyroid and parathyroid disease at Ito Hospital. Patients whose surgery included sternotomy or resection of the trachea, larynx, pharynx, or esophagus were excluded. AMP consisted of 2 g of piperacillin (PIPC) (group A, n = 541) or 1 g of cefazolin (CEZ) (group B, n = 541) administered intravenously immediately after endotracheal intubation. Patients in the control group (Group C, n = 1,082) did not receive AMP.

Results

Statistical analysis was performed to compare the AMP group (Group A + Group B) with the control group (Group C). Drug-induced acute reactions correlated to PIPC or CEZ did not occur in the AMP group. No significant differences in the postoperative incidence of liver or renal dysfunction were seen between the AMP and control groups. Postoperative incidence of urinary tract infection was significantly higher in the control group (p = 0.002). The incidence of SSI events was very low, with only 1 event (0.09 %) in the AMP group and 3 events (0.28 %) in the control group, and this difference between groups was not significant (p = 0.371).

Conclusions

AMP is not necessary to prevent SSI after clean thyroid or parathyroid surgery.

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References

  1. Zambudio AR, Rodriguez J, Riquelme J et al (2004) Prospective study of postoperative complications after total thyroidectomy for multinodular goiters by surgeons with experience in endocrine surgery. Ann Surg 240:18–25

    Article  PubMed Central  PubMed  Google Scholar 

  2. Johnson JT, Wagner RL (1987) nfection following uncontaminated head and neck surgery. Arch Otolaryngol Head Neck Surg 113:368–369

    Article  CAS  PubMed  Google Scholar 

  3. Flynn MB, Lyons KJ, Tarter JW et al (1994) Local complications after surgical resection for thyroid carcinoma. Am J Surg 168:404–407

    Article  CAS  PubMed  Google Scholar 

  4. Moulton-Barrett R, Crumley R, Jalilie S et al (1997) Complications of thyroid surgery Int Surg 82:63–66

    CAS  Google Scholar 

  5. Brown BM, Johnson JT, Wagner RL (1987) Etiologic factors in head and neck wound infections. Laryngoscope 97:587–590

    Article  CAS  PubMed  Google Scholar 

  6. Tabet JC, Johnson JT (1990) Wound infection in head and neck surgery: prophylaxis, etiology and management. J Otolaryngol 19:197–200

    CAS  PubMed  Google Scholar 

  7. Dionigi G, Rovera F, Boni L et al (2006) Surgical site infections after thyroidectomy. Surg Infect (Larchmt) 7(Suppl 2):S117–S120

    Google Scholar 

  8. Qin Q, Li H, Wang LB et al (2014) Thyroid surgery without antibiotic prophylaxis: experiences with 1,030 patients from a teaching hospital in China. World J Surg 38:878–881

    Article  PubMed  Google Scholar 

  9. ASHP (1999) Therapeutic guidelines on antimicrobial prophylaxis in surgery. American Society of Health-System Pharmacists. Am J Health Syst Pharm 56:1839–1888

  10. Gentile I, Rosato L, Avenia N et al (2012) Do Italian surgeons use antibiotic prophylaxis in thyroid surgery? Results from a national study (UEC—Italian Endocrine Surgery Units Association) Ann Ital Chir

  11. Moalem J, Ruan DT, Farkas RL et al (2010) Patterns of antibiotic prophylaxis use for thyroidectomy and parathyroidectomy: results of an international survey of endocrine surgeons. J Am Coll Surg 210:949–956

    Article  PubMed  Google Scholar 

  12. Mangram AJ, Horan TC, Pearson ML et al (1999) Guideline for prevention of surgical site infection, 1999. Centers for Disease Control and Prevention (CDC) Hospital Infection Control Practices Advisory Committee. Am J Infect Control 27:97–132; quiz 133–134; discussion 196

  13. Watanabe A, Kohnoe S, Sonoda H et al (2012) Effect of intra-abdominal absorbable sutures on surgical site infection. Surg Today 42:529–559

    Google Scholar 

  14. Togo S, Kubota T, Takahashi T et al (2008) Usefulness of absorbable sutures in preventing surgical site infection in hepatectomy. J Gastrointest Surg 12:1041–1046

    Article  PubMed  Google Scholar 

  15. Kuboki A, Nakayama T, Konno W et al (2013) New technique using an energy-based device versus conventional technique in open thyroidectomy Auris Nasus Larynx 40:558–562

    Google Scholar 

  16. Ruggiero R, Gubitosi A, Conzo G et al (2014) Sutureless thyroidectomy Int J Surg 12(Suppl 1):S189–S193

    Article  Google Scholar 

  17. Hooton TM, Bradley SF, Cardenas DD et al (2010) Diagnosis, prevention, and treatment of catheter-associated urinary tract infection in adults: 2009 International Clinical Practice Guidelines from the Infectious Diseases Society of America. Clin Infect Dis 50:625–663

    Article  PubMed  Google Scholar 

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Acknowledgments

The authors are grateful to the medical staff and members of the Division of Health Information Management of Ito Hospital, with particular thanks to Ms. Mayumi Tanaka for her precise data managements.

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Authors and Affiliations

  1. Department of Surgery, Ito Hospital, 4-3-6 Jingumae, Shibuya-ku, Tokyo, 150-8308, Japan

    Takashi Uruno, Chie Masaki, Akifumi Suzuki, Keiko Ohkuwa, Hiroshi Shibuya, Wataru Kitagawa, Mitsuji Nagahama, Kiminori Sugino & Koichi Ito

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  1. Takashi Uruno
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  2. Chie Masaki
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  3. Akifumi Suzuki
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  4. Keiko Ohkuwa
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  5. Hiroshi Shibuya
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  6. Wataru Kitagawa
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  7. Mitsuji Nagahama
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  8. Kiminori Sugino
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  9. Koichi Ito
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Correspondence to Takashi Uruno.

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Uruno, T., Masaki, C., Suzuki, A. et al. Antimicrobial Prophylaxis for the Prevention of Surgical Site Infection After Thyroid and Parathyroid Surgery: A Prospective Randomized Trial. World J Surg 39, 1282–1287 (2015). https://doi.org/10.1007/s00268-014-2932-1

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  • DOI: https://doi.org/10.1007/s00268-014-2932-1

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