Extended antibiotic prophylaxis for prevention of surgical-site infections in morbidly obese women who undergo combined hysterectomy and medically indicated panniculectomy: a cohort study

Sherif A. El-Nashar, Courtenay L. Diehl, Casey L. Swanson, Rodney L. Thompson, William Arthur Cliby, Abimbola O. Famuyide, C. Robert Stanhope

Research output: Contribution to journalArticle

20 Citations (Scopus)

Abstract

Objective: The purpose of this study was to compare surgical-site infection rates in obese women who had extended prophylactic antibiotic (EPA) vs standard prophylactic antibiotic. Study Design: An electronic records-linkage system identified 145 obese women (body mass index, >30 kg/m2) who underwent combined hysterectomy and panniculectomy from January 1, 2005, through December 31, 2008. The EPA cohort received standard antibiotics (cefazolin, 2 g) and continued oral antibiotic (ciprofloxacin) until removal of drains. Regression models were used to adjust for known confounders. Results: The mean age was 56.0 ± 12.1 years, and mean body mass index was 42.6 ± 8.4 kg/m2 (range, 30-86.4 kg/m2). The EPA cohort experienced fewer surgical-site infections (6 [5.9%] vs 12 [27.9%]; P < .001; adjusted odds ratio, 0.16; 95% confidence interval, 0.04-0.51; P < .001), had lower probability of incision and drainage (3 [2.9%] vs 5 [11.6%]; P = .05), and required fewer infection-related admissions (5 [4.9%] vs 6 [13.9%]; P = .08). Conclusion: Extended antibiotic prophylaxis can reduce surgical-site infections in obese women after combined hysterectomy and panniculectomy.

Original languageEnglish (US)
JournalAmerican Journal of Obstetrics and Gynecology
Volume202
Issue number3
DOIs
StatePublished - Mar 2010

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Abdominoplasty
Surgical Wound Infection
Antibiotic Prophylaxis
Hysterectomy
Cohort Studies
Anti-Bacterial Agents
Body Mass Index
Cefazolin
Ciprofloxacin
Drainage
Odds Ratio
Confidence Intervals
Infection

Keywords

  • hysterectomy
  • panniculectomy
  • prophylactic antibiotic
  • surgical-site infection

ASJC Scopus subject areas

  • Obstetrics and Gynecology

Cite this

Extended antibiotic prophylaxis for prevention of surgical-site infections in morbidly obese women who undergo combined hysterectomy and medically indicated panniculectomy : a cohort study. / El-Nashar, Sherif A.; Diehl, Courtenay L.; Swanson, Casey L.; Thompson, Rodney L.; Cliby, William Arthur; Famuyide, Abimbola O.; Stanhope, C. Robert.

In: American Journal of Obstetrics and Gynecology, Vol. 202, No. 3, 03.2010.

Research output: Contribution to journalArticle

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abstract = "Objective: The purpose of this study was to compare surgical-site infection rates in obese women who had extended prophylactic antibiotic (EPA) vs standard prophylactic antibiotic. Study Design: An electronic records-linkage system identified 145 obese women (body mass index, >30 kg/m2) who underwent combined hysterectomy and panniculectomy from January 1, 2005, through December 31, 2008. The EPA cohort received standard antibiotics (cefazolin, 2 g) and continued oral antibiotic (ciprofloxacin) until removal of drains. Regression models were used to adjust for known confounders. Results: The mean age was 56.0 ± 12.1 years, and mean body mass index was 42.6 ± 8.4 kg/m2 (range, 30-86.4 kg/m2). The EPA cohort experienced fewer surgical-site infections (6 [5.9{\%}] vs 12 [27.9{\%}]; P < .001; adjusted odds ratio, 0.16; 95{\%} confidence interval, 0.04-0.51; P < .001), had lower probability of incision and drainage (3 [2.9{\%}] vs 5 [11.6{\%}]; P = .05), and required fewer infection-related admissions (5 [4.9{\%}] vs 6 [13.9{\%}]; P = .08). Conclusion: Extended antibiotic prophylaxis can reduce surgical-site infections in obese women after combined hysterectomy and panniculectomy.",
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