Antibiotic Prophylaxis in Clean Surgery. Impact on Surgical Site Infection
Antibiotic Prophylaxis in Clean Surgery. Impact on Surgical Site Infection
This is a randomized control study of antibiotic uses in clean non prosthetic surgeries. One
 group will be given antibiotic prophylaxis, other will receive a placebo. The primary outcome
 will be the rate of surgical site infection in 2 groups.
I will conduct a randomized controlled trial (RCT) of antibiotic prophylaxis versus placebo
 in clean, non-prosthetic, elective procedures. The intervention will be a single dose of
 prophylactic antibiotic (cefazolin): 2 gr in adults or 3 gr for patients weighing >120Kg and
 30mg/kg in children) within 30-60 minutes prior to skin incision. The control group will
 receive a similarly prepared placebo injection (water for injection) 30-60 minutes prior to
 incision.

 I will randomize patients in a 1:1 allocation ratio using a simple randomization. Patients
 will randomly pick an envelope with a number allocating to antibiotic prophylaxis or placebo.
 Patients and caretakers will be blinded to the intervention. The surgeon will also be blinded
 to the intervention. The antibiotic (or placebo) will be pre-mixed by the study investigator
 and administered by the anesthetist.

 Other preventive measures for surgical site infection (SSIs) such as effective surgical hand
 scrub, proper skin preparation with povidone and sterility of materials and instrument will
 be applied systematically in all groups. Dressing of the wound will be removed 48 hours after
 operation and no further dressing will be required. Patients will be followed for development
 of SSI documented by surgeon at discharge and will be called after 30 days of surgery to
 address any sign of SSI.
Inclusion Criteria:

 -  - All elective non-prosthetic surgical procedures such as hernia, thyroid, hydrocele,
 undescended testes surgery, removal of orthopedic implants, low risk breast surgical
 procedures and other all procedures deemed to be clean.

 Exclusion Criteria:

 -  - Emergency cases

 -  Any patient with American Society of Anesthesiologists Score (ASA)>2

 -  Procedures lasting more than 2 hours

 -  Patients who were taking antibiotics 2 days prior to operation