Surgical Site Infections after Laparoscopic Bariatric Surgery: Is Routine Antibiotic Prophylaxis Required?

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dc.authoridSumer, Fatih/0000-0002-0557-1369
dc.authoridGunes, Orgun/0000-0002-0576-6086
dc.authoridBag, Yusuf Murat/0000-0002-0159-9356
dc.authoridAktas, Aydin/0000-0003-3407-0210
dc.authoridArslan, Ufuk/0000-0002-3050-167X
dc.authorwosidSumer, Fatih/F-8042-2017
dc.authorwosidGunes, Orgun/GLN-4395-2022
dc.authorwosidBag, Yusuf Murat/ABD-2949-2021
dc.authorwosidKayaalp, Cuneyt/AAH-1764-2021
dc.authorwosidAktas, Aydin/AAC-3425-2021
dc.authorwosidArslan, Ufuk/AAZ-4076-2021
dc.contributor.authorAktas, Aydin
dc.contributor.authorKayaalp, Cuneyt
dc.contributor.authorGunes, Orgun
dc.contributor.authorKirkil, Cuneyt
dc.contributor.authorTardu, Ali
dc.contributor.authorAydin, Mehmet Can
dc.contributor.authorBag, Yusuf Murat
dc.date.accessioned2024-08-04T20:50:38Z
dc.date.available2024-08-04T20:50:38Z
dc.date.issued2021
dc.departmentİnönü Üniversitesien_US
dc.description.abstractBackground: It is a challenging question, especially in bariatric surgery (BS), whether antibiotic prophylaxis is necessary in all cases; considering the serious consequences of surgical site infection (SSI) on the one hand and irrational use of antibiotics on the other. The aim of this study was to determine the need/rationale for antibiotic prophylaxis in patients undergoing laparoscopic bariatric surgery, especially low-risk patients. Methods: This retrospective analysis involved 313 morbidly obese patients (body Mass Index [BMI] >= 40) who underwent laparoscopic BS at three medical centers between September 2018 and June 2019. During the trial, no inducement was given to use antibiotics, and the centers had chosen whether to use prophylaxis. The U.S. Centers for Disease Control and Prevention (CDC)-2016 criteria were used for the diagnosis of SSI. Results: Antibiotic prophylaxis was given to 181 patients, and the SSI rate in the entire series was 4.5% (14/313). There was no significant difference in SSI between the group who received antibiotics and that who did not (2.8% versus 6.8%, respectively; p = 0.09). Post-operative intra-abdominal complications were the main independent determinant for SSIs (p < 0.001). Antibiotic prophylaxis did not have any significant effect on the rate of SSI caused by these complications (2.2% versus 3.8%, respectively; p = 0.50). The second independent factor was the rate of SSI in patients with super-obesity (BMI >= 60), particularly incisional SSIs (p < 0.001). Antibiotic prophylaxis did not produce any significant decrease in the rate of SSI in patients with a BMI < 60 (2.8% versus 5.5%, respectively; p = 0.24). When these two independent factors were excluded, there were no patients with SSI in the no-antibiotics group, and only one in the antibiotic prophylaxis group (0.5%) (p = 1.00). Conclusions: Routine antibiotic prophylaxis should be questioned in laparoscopic BS. Prophylaxis may reduce incisional SSI in patients with a BMI of >= 60. In other cases, antibiotic prophylaxis does not provide a decrease in SSIen_US
dc.identifier.doi10.1089/sur.2020.426
dc.identifier.endpage712en_US
dc.identifier.issn1096-2964
dc.identifier.issn1557-8674
dc.identifier.issue7en_US
dc.identifier.pmid33416442en_US
dc.identifier.scopus2-s2.0-85114352608en_US
dc.identifier.scopusqualityQ2en_US
dc.identifier.startpage705en_US
dc.identifier.urihttps://doi.org/10.1089/sur.2020.426
dc.identifier.urihttps://hdl.handle.net/11616/100187
dc.identifier.volume22en_US
dc.identifier.wosWOS:000606626400001en_US
dc.identifier.wosqualityQ3en_US
dc.indekslendigikaynakWeb of Scienceen_US
dc.indekslendigikaynakScopusen_US
dc.indekslendigikaynakPubMeden_US
dc.language.isoenen_US
dc.publisherMary Ann Liebert, Incen_US
dc.relation.ispartofSurgical Infectionsen_US
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanıen_US
dc.rightsinfo:eu-repo/semantics/closedAccessen_US
dc.subjectantibiotic prophylaxisen_US
dc.subjectmorbid obesityen_US
dc.subjectone-anastomosis gastric bypassen_US
dc.subjectRoux-en-Y gastric bypassen_US
dc.subjectsleeve gastrectomyen_US
dc.titleSurgical Site Infections after Laparoscopic Bariatric Surgery: Is Routine Antibiotic Prophylaxis Required?en_US
dc.typeArticleen_US

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