Surgical Antimicrobial Prophylaxis in Pediatric Patients Undergoing Plastic Surgery: A RAND/UCLA Appropriateness Method Consensus Study

Antibiotics

on behalf of the Peri-Operative Prophylaxis in Neonatal and Paediatric Age (POP-NeoPed) Study Group¹  Mario Giuffré²  Annamaria Staiano³  Andrea Lo Vecchio³  Daniele Donà⁴  Stefania La Grutta⁵  Carlo Pietrasanta⁶  Matilde Ciccia⁷  Laura Lancella⁸  Alessandro Simonini⁹  Erika Rigotti^1,10  Marilia Di Pietro^1,10  Giorgio Piacentini^1,10  Roberta Opri^1,10  Susanna Esposito^1,11  Laura Nicoletti^1,11  Sara Monaco^1,11  Sonia Bianchini^1,11  Giorgio Conti^1,12  Elisabetta Venturini^1,13  Gloria Pelizzo^1,14  Mario Lima^1,15  Matteo Puntoni^1,16  Caterina Caminiti^1,16  Rossella Sgarzani^1,17  Nicola Principi^1,18 

[1] ;Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties “G. D’Alessandro”, University of Palermo, 90141 Palermo, Italy;Department of Translational Medical Science, Section of Pediatrics, University of Naples “Federico II”, 80138 Naples, Italy;Division of Paediatric Infectious Diseases, Department for Woman and Child Health, University of Padua, 35100 Padua, Italy;Institute of Translational Pharmacology IFT, National Research Council, 90146 Palermo, Italy;Neonatal Intensive Care Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Department of Mother, Child and Infant, 20122 Milan, Italy;Neonatology and Neonatal Intensive Care Unit, Ospedale Maggiore, 40133 Bologna, Italy;Paediatric and Infectious Disease Unit, Academic Department of Pediatrics, IRCCS Bambino Gesù Children’s Hospital, 00165 Rome, Italy;Pediatric Anesthesia and Intensive Care Unit, Salesi Children’s Hospital, 60123 Ancona, Italy;Pediatric Clinic, Azienda Ospedaliera Universitaria Integrata, 37134 Verona, Italy;Pediatric Clinic, University Hospital, Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy;Pediatric ICU and Trauma Center, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00165 Rome, Italy;Pediatric Infectious Disease Unit, Meyer’s Children Hospital, 50139 Florence, Italy;Pediatric Surgery Department, “Vittore Buzzi” Children’s Hospital, 20154 Milano, Italy;Pediatric Surgery, IRCCS Azienda Ospedaliera-Universitaria di Bologna, 40138 Bologna, Italy;Research and Innovation Unit, University Hospital of Parma, 43126 Parma, Italy;Servizio di Chirurgia Plastica, Centro Grandi Ustionati, Ospedale M. Bufalini, AUSL Romagna, 47521 Cesena, Italy;Università degli Studi di Milano, 20122 Milan, Italy;

关键词: antibiotics;    burn;    pediatric infectious diseases;    plastic surgery;    surgical antibiotic prophylaxis;    wound;   

DOI  :  10.3390/antibiotics11040506

来源: DOAJ

【 摘 要 】

For many years, it was clearly shown that surgical procedures might be associated with surgical site infection (SSI). Many scientific institutions prepared guidelines to use in surgery to reduce abuse and misuse of antibiotics. However, in the general guidelines for surgical antibiotic prophylaxis, plastic surgical procedures are not addressed or are only marginally discussed, and children were almost systematically excluded. The main aim of this Consensus document is to provide clinicians with recommendations on antimicrobial prophylaxis for pediatric patients undergoing plastic surgery. The following scenarios were considered: clean plastic surgery in elective procedures with an exclusive skin and subcutis involvement; clean-contaminated/contaminated plastic surgery in elective procedures with an exclusive skin and subcutis involvement; elective plastic surgery with use of local flaps; elective plastic surgery with the use of grafts; prolonged elective plastic surgery; acute burns; clean contused lacerated wounds without bone exposure; high-risk contused lacerated wounds or with bone exposure; contused lacerated wound involving the oral mucosa; plastic surgery following human bite; plastic surgery following animal bite; plastic surgery with tissue expander insertion. Our Consensus document shows that antimicrobial perioperative prophylaxis in pediatric patients undergoing plastic surgery is recommended in selected cases. While waiting the results of further pediatric studies, the application of uniform and shared protocols in these procedures will improve surgical practice, with a reduction in SSIs and consequent rationalization of resources and costs, as well as limiting the phenomenon of antimicrobial resistance.

【 授权许可】

Unknown