Antibiotic prophylaxis in surgery. (SIGN Guideline No 104)

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Antibiotic prophylAxis in surgery 58 Annex 2 CDC criteria for defining a surgical site infection 216 superficial incisional ssi Infection occurs within 30 days after the operation and infection involves only skin of subcutaneous tissue of the incision and at least one of the following: 1. 2. 3. 4. purulent drainage, with or without laboratory confirmation, from the superficial incision organisms isolated from an aseptically obtained culture of fluid or tissue from the superficial incision at least one of the following signs or symptoms of infection: pain or tenderness localised swelling redness heat and superficial incision deliberately opened by a surgeon, unless incision is culturenegative diagnosis of superficial incisional SSI by the surgeon or attending physician. Do not report the following conditions as SSI: 1. 2. 3. 4. stitch abscess (minimal inflammation and discharge confined to the points of suture penetration) infection of an episiotomy or newborn circumcision site infected burn wound incisional SSI that extends into the fascial and muscle layers (see deep incisional SSI). Note: Specific criteria are used for identifying infected episiotomy and circumcision sites and burn wounds. Deep incisional ssi Infection occurs within 30 days after the operation if no implant is left in place or within one year if implant is in place and the infection appears to be related to the operation and infection involves deep soft tissues (eg fascial and muscle layers) of the incision and at least one of the following: 1. 2. 3. 4. purulent drainage from the deep incision but not from the organ/space component of the surgical site a deep incision spontaneously dehisces or is deliberately opened by a surgeon when the patient has at least one of the following signs or symptoms: fever (>38°C) localised pain tenderness unless site is culture-negative an abscess or other evidence of infection involving the deep incision is found on direct examination, during reoperation, or by histopathological or radiological examination diagnosis of deep incisional SSI by a surgeon or attending physician. Notes: Report infection that involves both superficial and deep incision sites as deep incisional SSI. Report an organ/space SSI that drains through the incision as deep incisional SSI.
Annex 2 (continued) organ/space ssi Infection occurs within 30 days after the operation if no implant is left in place or within one year if implant is in place and the infection appears to be related to the operation and infection involves any part of the anatomy (eg organs or spaces), other than the incision, which was opened or manipulated during an operation and at least one of the following: 1. 2. 3. 4. purulent discharge from a drain that is placed through a stab wound into the organ/ space organisms isolated from an aseptically obtained culture of fluid or tissue in the organ/ space an abscess or other evidence of infection involving the organ/space that is found on direct examination, during reoperation, or by histopathologic or radiological examination diagnosis of an organ/space SSI by a surgeon or attending physician. Annexes 59
Page 1 and 2:
SIGN Scottish Intercollegiate Guide
Page 3 and 4:
Scottish Intercollegiate Guidelines
Page 5 and 6:
contents 1 introduction ...........
Page 7 and 8:
1 introduction 1.1 the neeD for A g
Page 9 and 10:
1.3 Definitions Prophylactic antibi
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2.3 implementing the guiDeline ; ;
Page 13 and 14: Table 2 ASA classification of physi
Page 15 and 16: 4 benefits and risks of antibiotic
Page 17 and 18: other symptomatologies show either
Page 19 and 20: 5 indications for surgical antibiot
Page 21 and 22: Operation Recommendation Odds Ratio
Page 35 and 36: 6 Administration of prophylactic an
Page 37 and 38: 6.3 DosAge selection It is generall
Page 39 and 40: Results from studies on the use of
Page 41 and 42: 7 provision of information 7.1 proV
Page 43 and 44: 7.4.2 INTERNATIoNAl oRGANISATIoNS c
Page 45 and 46: 8.2 possible cost-effectiVeness Dec
Page 47 and 48: 8.3 implementAtion Guideline implem
Page 49 and 50: In the uK, the national mandatory s
Page 51 and 52: facial surgery facial skin surgery,
Page 53 and 54: 10 Development of the guideline 10.
Page 55 and 56: 10.2.2 ACKNoWlEDGEMENTS SIGN would
Page 57 and 58: Abbreviations AAD antibiotic-associ
Page 59 and 60: Annex 1 Key questions used to devel
Page 61 and 62: 13. Is antibiotic prophylaxis recom
Page 63: ADMINISTRATIoN oF PRoPHYlACTIC ANTI
Page 67 and 68: Annex 4 Table of common pathogens S
Page 69 and 70: Annex 6 Calculating the cost effect
Page 71 and 72: eferences 1. Scottish Intercollegia
Page 73 and 74: 93. Da Costa A, Kirkorian G, Cucher
Page 75 and 76: 173. Kampougeris G, Antoniadou A, K
Page 78: ISBN 978 1 905813 34 6 Scottish Int
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Antibiotic prophylaxis in surgery. (SIGN Guideline No 104)

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