Impact of the timing of antibiotic prophylaxis on the surgical site infections in patients undergoing elective general surgery.

Introduction: Surgical site infections are one of the major challenges in surgical practice. The antibiotic prophylaxis, though scientific, still lacks clarity on the timing of the administration of the drugs.

Methods: An interventional study was planned in the Department of General Surgery at PGIMER, Chandigarh. One hundred twenty-seven patients who met the inclusion and exclusion criteria were enrolled. They were divided into two groups using a table of random numbers into Group A (n = 67) where the drug was administered 0-30 min before incision, and Group B (n = 60) where the drug was injected 30-60 min before incision. Both the surgical team and the investigator for the SSI were blinded.

Results: The distribution of sex ratio, comorbidities, and the hematological parameters was equal among groups. The mean blood loss, operative times, and the type of surgical procedures were also distributed equally. There was significantly low SSI in Group A (n = 2) versus Group B (n = 8) (P = 0.03). Drains were placed in 41 patients; 9 out of the 10 patients who reported SSI had an intraoperative drain placed. The placement of the drain was significantly associated with SSI (P < 0.001).

Conclusions: Administering prophylactic antibiotics within 30 min before the surgical incision is effective. Placement of the Drain must be avoided to prevent SSI.