Cerrahi Branşlara Göre Yapılan Ameliyatlarda Antibiyotik Proflaksi Klavuzu

Yıl 2008, Cilt: 5 Sayı: 1, 43 - 54, 01.04.2008

Ali Uzunköy

Öz

Genel cerrahi operasyonları temiz yaralardan, kirli yaralara kadar geniş bir alana yayılmıştır. Proflaksi seçiminde en önemli faktör yaranın kontaminasyon derecesidir. Temiz cerrahi yaralar için seçilecek antibiyotik Sefazolin veya Sefuroksim’dir. Özellikle kolorektal cerrahide barsak hazırlığı ile birlikte anaeroblara etkili bir antibiyotiğin Metranidazol, Ornidazol gibi seçilmesi önerilmektedir. Tiroidektomide, splenektomide antibiyotik proflaksisi önerilmemektedir. Fıtık ameliyatlarında greft kullanılmamış ise proflaksiye gerek yoktur. Meme cerrahisinde de proflaksi önerilmemektedir. Bununla birlikte fıtık cerrahisi ve meme cerrahisinde proflaksi uygulayanlar vardır. Yüksek selektif vagatomi ve Nissen fundoplikasyonunda da AP önerilmektedir. Karaciğer ve pankreas cerrahisinde proflaksi uygulaması tartışmalıdır.

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