Antibiotic prophylaxis in foot and ankle surgery: a systematic review of the literature
Abstract Background With the advent of bacterial resistance, it is important now more than ever to evaluate use of antibiotic chemoprophylaxis in foot and ankle surgery. Within this area of the body there may be less dissection, surgery time with smaller incisions and importantly smaller sizes of im...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2018-11-01
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| Series: | Journal of Foot and Ankle Research |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s13047-018-0303-0 |
| _version_ | 1797225610855055360 |
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| author | Mr Ravi Krishān Modha Chris Morriss-Roberts Madeleine Smither Jonathan Larholt Ian Reilly |
| author_facet | Mr Ravi Krishān Modha Chris Morriss-Roberts Madeleine Smither Jonathan Larholt Ian Reilly |
| author_sort | Mr Ravi Krishān Modha |
| collection | DOAJ |
| description | Abstract Background With the advent of bacterial resistance, it is important now more than ever to evaluate use of antibiotic chemoprophylaxis in foot and ankle surgery. Within this area of the body there may be less dissection, surgery time with smaller incisions and importantly smaller sizes of implanted fixation as compared to other bone and joint procedures. Our objective was to systematically evaluate the quality of evidence behind existing guidelines. Methodology A systematic literature search was performed: MEDLINE, CINHAL, EMBASE and the Cochrane library from 1990 up to March 2018. To avoid omitting any studies on the subject, Google Scholar was also used. The inclusion criterion were studies exploring perioperative antibiotic use, postoperative infection rates in elective foot and ankle surgery and studies associated with this subject evaluating antibiotic use in clean elective foot and ankle surgery. The exclusion criterion being studies upon contaminated or dirty surgery or those which were inclusive of procedures proximal to the foot and ankle. Results Overall 11 studies met the inclusion criteria. From the grading of evidence, 2 level one and 4 level two studies were recognised. These studies ranked relatively highly in comparison to 5 studies that were graded as level three and level four tiers of evidence. Results of SSI rates found within this systematic review ranged from 0% to 9.4% of overall postoperative infections encountered after foot and ankle surgery in the studies analysed. Conclusion Whilst fragmented, aspects of antibiotic chemoprophylaxis are established fields in elective surgery with a growing body of evidence. Evidence for antibiotic use however, specifically within elective foot and ankle surgery, is lacking. This systematic review is a seminal paper which delivers an impression of the most influential literature within the field of foot and ankle surgery, with the aim being to entice conclusions and guide future research. |
| first_indexed | 2024-03-08T07:20:13Z |
| format | Article |
| id | doaj.art-4489d9d1e17a44d4959c7bfc076499ac |
| institution | Directory Open Access Journal |
| issn | 1757-1146 |
| language | English |
| last_indexed | 2024-04-24T14:11:45Z |
| publishDate | 2018-11-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of Foot and Ankle Research |
| spelling | doaj.art-4489d9d1e17a44d4959c7bfc076499ac2024-04-03T09:01:48ZengWileyJournal of Foot and Ankle Research1757-11462018-11-0111111410.1186/s13047-018-0303-0Antibiotic prophylaxis in foot and ankle surgery: a systematic review of the literatureMr Ravi Krishān Modha0Chris Morriss-Roberts1Madeleine Smither2Jonathan Larholt3Ian Reilly4Department of Podiatric Surgery, Ilkeston HospitalDepartment of Podiatric Surgery, Ilkeston HospitalDepartment of Podiatric Surgery, Ilkeston HospitalDepartment of Podiatric Surgery, Ilkeston HospitalDepartment of Podiatric Surgery, Ilkeston HospitalAbstract Background With the advent of bacterial resistance, it is important now more than ever to evaluate use of antibiotic chemoprophylaxis in foot and ankle surgery. Within this area of the body there may be less dissection, surgery time with smaller incisions and importantly smaller sizes of implanted fixation as compared to other bone and joint procedures. Our objective was to systematically evaluate the quality of evidence behind existing guidelines. Methodology A systematic literature search was performed: MEDLINE, CINHAL, EMBASE and the Cochrane library from 1990 up to March 2018. To avoid omitting any studies on the subject, Google Scholar was also used. The inclusion criterion were studies exploring perioperative antibiotic use, postoperative infection rates in elective foot and ankle surgery and studies associated with this subject evaluating antibiotic use in clean elective foot and ankle surgery. The exclusion criterion being studies upon contaminated or dirty surgery or those which were inclusive of procedures proximal to the foot and ankle. Results Overall 11 studies met the inclusion criteria. From the grading of evidence, 2 level one and 4 level two studies were recognised. These studies ranked relatively highly in comparison to 5 studies that were graded as level three and level four tiers of evidence. Results of SSI rates found within this systematic review ranged from 0% to 9.4% of overall postoperative infections encountered after foot and ankle surgery in the studies analysed. Conclusion Whilst fragmented, aspects of antibiotic chemoprophylaxis are established fields in elective surgery with a growing body of evidence. Evidence for antibiotic use however, specifically within elective foot and ankle surgery, is lacking. This systematic review is a seminal paper which delivers an impression of the most influential literature within the field of foot and ankle surgery, with the aim being to entice conclusions and guide future research.http://link.springer.com/article/10.1186/s13047-018-0303-0Antibiotic prophylaxisFoot surgeryFoot and ankle surgeryAntibiotic chemoprophylaxisSurgical site infectionPostoperative infection |
| spellingShingle | Mr Ravi Krishān Modha Chris Morriss-Roberts Madeleine Smither Jonathan Larholt Ian Reilly Antibiotic prophylaxis in foot and ankle surgery: a systematic review of the literature Journal of Foot and Ankle Research Antibiotic prophylaxis Foot surgery Foot and ankle surgery Antibiotic chemoprophylaxis Surgical site infection Postoperative infection |
| title | Antibiotic prophylaxis in foot and ankle surgery: a systematic review of the literature |
| title_full | Antibiotic prophylaxis in foot and ankle surgery: a systematic review of the literature |
| title_fullStr | Antibiotic prophylaxis in foot and ankle surgery: a systematic review of the literature |
| title_full_unstemmed | Antibiotic prophylaxis in foot and ankle surgery: a systematic review of the literature |
| title_short | Antibiotic prophylaxis in foot and ankle surgery: a systematic review of the literature |
| title_sort | antibiotic prophylaxis in foot and ankle surgery a systematic review of the literature |
| topic | Antibiotic prophylaxis Foot surgery Foot and ankle surgery Antibiotic chemoprophylaxis Surgical site infection Postoperative infection |
| url | http://link.springer.com/article/10.1186/s13047-018-0303-0 |
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