Prospective study of preincisional single-dose ceftriaxone in reducing postoperative wound infection in high risk of infection patients.

Background/aims: The risk of wound contamination in high risk of infection patients after abdominal operations is well recognised. Preincisional intraparietal injection of antibiotics is used for the prophylaxis of postoperative surgical infections. Whether topically injected antibiotics remain primarily in the surgical wound or are systematically absorbed is uncertain, however.

Patients And Methods: The pharmacokinetic of preincisional injection of 2 g Ceftriaxone were studied in 50 high risk of infection patients (diabetic, oncologic, immunocompromised and obese) who have undergone abdominal surgery, with determination of serum, wound tissue, and wound fluid antibiotic concentrations.

Results: Preincisional injection of Ceftriaxone resulted in high antibiotic concentrations in the wound fluid. The highest plasma concentrations were achieved at 1 1/2 hours (98.30 SD 14.10 micrograms/ml). Plasma concentrations exceeded the minimal inhibitory concentrations of most aerobic gram positive and gram negative organisms with the exception of Pseudomonas aeruginosa, Acinobacter species, and Streptococcus faecalis for 24 hours (10.10 SD 4.00 micrograms/ml). No longer of general complications were arose in any of the patients.

Conclusion: Our results suggest that preincisional administration of ceftriaxone for prophylaxis of the wound sepsis in high risk of infection patients is very effective.