The Efficacy of Prophylactic Single Dose Intravenous Antibiotics vs. Multi Dose Intravenous/Oral Antibiotics in Elective Foot and Ankle Surgery

Muhammad Eisa Dror Robinson Mustafa Yassin Eyal Heller Avraham Garti
Department of Orthopedics, Hasharon Hospital, Petah Tikwa, Israel

A prospective evaluation of wound healing of 675 patients who received elective foot and ankle surgeries between 2011 and 2015 at 1 hospital clinic was performed to evaluate the effect of two prophylactic antibiotic regimens. Only those patients who were having elective foot or ankle surgery and were being followed up at the hospital’s outpatient clinic, patients had a traumatic or nontraumatic cause for their surgery. The ASEPSIS classification system was used to define wound healing with a grade of more than 20 considered effective. Two hundred and twenty patients (32.6%) patients received a single dose preoperative antibiotic and 455 (67.4%) patients received a prolonged prophylactic treatement. Of the 455 patients who received a prolonged antibiotic treatment, 444 had unimpaired healing (97.8%), 3 had impaired healing and the rest (8 patients, 1.5%) had postoperative infections. Among the single dose antibiotic group, 181 (82.7%) had normal healing, 24 (10.9%) had impaired healing and 15 (6.8%) had an infection. The intergroup difference was significant (ANOVA, p<0.001). The results suggest that prophylactic intravenous antibiotic use combined with post operative treatment in routine elective foot and ankle surgery might be expected to reduce the complication rates and impaired wound healing.