Đánh giá kết quả sử dụng kháng sinh dự phòng trong phẫu thuật chấn thương chỉnh hình

Surgical site infections (SSIs) represent a significant challenge in orthopedic trauma surgery, frequently leading to prolonged recovery periods, increased healthcare costs, and potentially severe complications such as osteomyelitis or permanent disability. Prophylactic antibiotic (PAB) administration is a cornerstone of infection prevention, playing a vital role in mitigating SSI rates and combating the broader issue of antimicrobial resistance. Despite international guidelines advocating for standardized PAB protocols, their uniform implementation and evaluation in clinical practice, particularly within the Vietnamese context, often lack comprehensive assessment. Therefore, this study was undertaken to evaluate the practical outcomes and effectiveness of prophylactic antibiotic use, specifically Cefazolin, in orthopedic trauma surgery patients at Military Hospital 103, thereby contributing to evidence-based practice in this critical area.

Chuyên gia y tế, bác sĩ phẫu thuật chấn thương chỉnh hình, dược sĩ lâm sàng, điều dưỡng, và các nhà quản lý y tế quan tâm đến phòng ngừa nhiễm khuẩn vết mổ.

This study assessed the effectiveness of prophylactic antibiotic (PAB) use, specifically Cefazolin, in preventing surgical site infections (SSIs) following orthopedic trauma surgery at Military Hospital 103. Conducted as a descriptive, longitudinal study from March to July 2025, it involved 293 patients undergoing clean orthopedic trauma procedures. All participants received preoperative Cefazolin according to established Ministry of Health guidelines, and SSIs were closely monitored for at least seven days post-surgery. The results were largely positive, with 95.9% of patients showing no signs of infection and not requiring additional antibiotic treatment. A minor proportion (2.4%) developed superficial SSIs, which were successfully managed without progressing to deep infections, while 1.7% of high-risk patients received supplementary antibiotics without confirmed infection. The research identified comorbidities, prolonged surgery, and complex surgical types as significant risk factors for SSIs, correlating with longer hospitalization periods. The study concludes that the appropriate administration of Cefazolin as a PAB substantially lowers SSI rates in orthopedic trauma surgery. Its findings underscore the critical importance of integrating PAB protocols with comprehensive infection control strategies, including stringent aseptic techniques, meticulous postoperative wound care, and vigilant patient monitoring. The observed reduction in superficial SSIs after the full implementation of aseptic protocols further highlights the paramount role of consistent adherence to such measures. This multi-faceted approach, encompassing not only antibiotic stewardship but also surgical best practices and continuous surveillance, is essential for optimizing patient outcomes and enhancing the overall quality of care in orthopedic trauma settings.