[Antibioprevention in reconstructive arterial surgery. A double-blind study]

Abstract

Routine antibiotic prophylaxis in reconstructive vascular surgery was established on a small number of controlled trials. A comparative double-blind study of cefazolin versus placebo was conducted in 179 patients who underwent reconstructive vascular surgery over a 23 month period. The surgical procedures were divided in three groups: aorto-iliac reconstructions (112 cases) infra-inguinal reconstructions (50 cases), extra anatomic by-passes (17 cases). The arterial diseases encountered and the systemic and local conditions in favour of infection were equal in the 2 randomized groups. Among the 93 patients who received cephazolin, 13 (13.97%) developed an infection which was systemic in 1 case and local in 12 cases; 1 amputation and 1 death were observed in this group. In the placebo group 26 patients among 86 (30.23%) developed an infection, systemic in 4 cases and local in 22 cases with 1 death and 1 amputation. Statistical analysis (chi-square test) showed a significant difference in favour of the active substance. A short time massive dose of antibiotic administered in the perioperative period is the best method to reduce the incidence of infection in this type of surgery.