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Methodology: This prospective randomized single blinded study included 534 patients. We included all ASA Grade 1 or 2, immunocompetent patients undergoing clean or clean contaminated surgery. Group A received placebo. Group B received single dose Cefuroxime 750mg iv preoperatively and Group C received triple regime. Any SSI was recorded which occurred up to 30 days post operatively.
Results: The three groups were well matched demographically. (p value < 0.05). Group A (43 patients) was terminated early due to unacceptably high rate of wound infection. Amongst the remaining 491 patients, 247 were randomized to Group B and 244 to Group C. Among the clean cases Group C showed a lower rate of infection (2.6% vs 2.8%; p=0.17). However, Group B had significantly lower infection among the clean contaminated procedures (6.9% vs 7.7%; p=0.03) and overall (4.1% vs 4.9%; p=0.04).
Conclusion: The high rate of infection demonstrated in patients receiving placebo indicates a need for routine chemoprophylaxis for SSI. A single dose of Cefuroxime at induction seems to work at least as well or better than triple regime and is the recommended prophylaxis.
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