INTERET DE L’ANTIBIOPROPHYLAXIE POST OPERATOIRE DANS LA PREVENTION DES INFECTIONS DU SITE OPERATOIRE EN CHIRURGIE DIGESTIVE.

Abstract

Background : The postoperative period is a crucial phase for all operated patients, requiring ultimate monitoring in order to detect complications that may arise, especially infections, in particular surgical site infection (SSI) .This remains a public health problem and a threat that is difficult to manage, hence the interest of recognizing all the arsenals aimed at prevention, antibiotic prophylaxis is the cornerstone of this and it must obey well-codified protocols. After having noticed the continuous and systematic prescription of antibiotics as a preventive measure after digestive surgery contrary to the recommendations, our study adopted the objective of evaluating the interest of postoperative antibiotic prophylaxis in the prevention of surgical site infections in digestive surgery. Materials and methods: our study was single-center prospective descriptive conducted in the general surgery department at the colonel Lotfi mixed hospital in Laghouat, over a period of 6 months from September 2022 to February 2023 ,where the series focused on patients operated for a digestive surgical pathology, whose intervention is class I or II of ALTEMEIER. Results: 100 digestive surgical procedures were included and all age groups are part of this series, 14 patients developed SSI with an incidence rate of 14.4%, a long duration of intervention, the degree of contamination from previous surgery, as well as prolonged hospital stay were risk factors for SSI. 80% of patients received postoperative antibiotic prophylaxis, of which 12 patients developed SSI. The comparative study of the two groups SSI + (population which developed SSI) and SSI – (population which did not develop SSI) has found that the administration of prophylactic antibiotics postoperatively does not reduce the risk of onset of SSI [SSI+: 12 (85.7%) vs SSI-: 68 (81.9%) p=0.73]. Conclusion: The specificity of the field and the particularity of the local conditions do not seem to be sufficient arguments to justify certain current medical practices outside the recommendations of learned societies such as the systematic prescription of ATBP after clean or clean contaminated surgery which must be imperatively replaced by a therapeutic strategy based on the concept of "evidence-based medicine". Key words: surgical site infection, antibiotic prophylaxis, digestive surgery