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

antibiotics burn pediatric infectious diseases plastic surgery surgical antibiotic prophylaxis wound

Journal

Antibiotics (Basel, Switzerland)
ISSN: 2079-6382
Titre abrégé: Antibiotics (Basel)
Pays: Switzerland
ID NLM: 101637404

Informations de publication

Date de publication:
11 Apr 2022
Historique:
received: 05 03 2022
revised: 05 04 2022
accepted: 07 04 2022
entrez: 23 4 2022
pubmed: 24 4 2022
medline: 24 4 2022
Statut: epublish

Résumé

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.

Identifiants

pubmed: 35453257
pii: antibiotics11040506
doi: 10.3390/antibiotics11040506
pmc: PMC9029976
pii:
doi:

Types de publication

Journal Article

Langues

eng

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Auteurs

Susanna Esposito (S)

Pediatric Clinic, University Hospital, Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy.

Rossella Sgarzani (R)

Servizio di Chirurgia Plastica, Centro Grandi Ustionati, Ospedale M. Bufalini, AUSL Romagna, 47521 Cesena, Italy.

Sonia Bianchini (S)

Pediatric Clinic, University Hospital, Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy.

Sara Monaco (S)

Pediatric Clinic, University Hospital, Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy.

Laura Nicoletti (L)

Pediatric Clinic, University Hospital, Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy.

Erika Rigotti (E)

Pediatric Clinic, Azienda Ospedaliera Universitaria Integrata, 37134 Verona, Italy.

Marilia Di Pietro (M)

Pediatric Clinic, Azienda Ospedaliera Universitaria Integrata, 37134 Verona, Italy.

Roberta Opri (R)

Pediatric Clinic, Azienda Ospedaliera Universitaria Integrata, 37134 Verona, Italy.

Caterina Caminiti (C)

Research and Innovation Unit, University Hospital of Parma, 43126 Parma, Italy.

Matilde Ciccia (M)

Neonatology and Neonatal Intensive Care Unit, Ospedale Maggiore, 40133 Bologna, Italy.

Giorgio Conti (G)

Pediatric ICU and Trauma Center, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00165 Rome, Italy.

Daniele Donà (D)

Division of Paediatric Infectious Diseases, Department for Woman and Child Health, University of Padua, 35100 Padua, Italy.

Mario Giuffré (M)

Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties "G. D'Alessandro", University of Palermo, 90141 Palermo, Italy.

Stefania La Grutta (S)

Institute of Translational Pharmacology IFT, National Research Council, 90146 Palermo, Italy.

Laura Lancella (L)

Paediatric and Infectious Disease Unit, Academic Department of Pediatrics, IRCCS Bambino Gesù Children's Hospital, 00165 Rome, Italy.

Mario Lima (M)

Pediatric Surgery, IRCCS Azienda Ospedaliera-Universitaria di Bologna, 40138 Bologna, Italy.

Andrea Lo Vecchio (A)

Department of Translational Medical Science, Section of Pediatrics, University of Naples "Federico II", 80138 Naples, Italy.

Gloria Pelizzo (G)

Pediatric Surgery Department, "Vittore Buzzi" Children's Hospital, 20154 Milano, Italy.

Giorgio Piacentini (G)

Pediatric Clinic, Azienda Ospedaliera Universitaria Integrata, 37134 Verona, Italy.

Carlo Pietrasanta (C)

Neonatal Intensive Care Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Department of Mother, Child and Infant, 20122 Milan, Italy.

Matteo Puntoni (M)

Research and Innovation Unit, University Hospital of Parma, 43126 Parma, Italy.

Alessandro Simonini (A)

Pediatric Anesthesia and Intensive Care Unit, Salesi Children's Hospital, 60123 Ancona, Italy.

Elisabetta Venturini (E)

Pediatric Infectious Disease Unit, Meyer's Children Hospital, 50139 Florence, Italy.

Annamaria Staiano (A)

Department of Translational Medical Science, Section of Pediatrics, University of Naples "Federico II", 80138 Naples, Italy.

Nicola Principi (N)

Università degli Studi di Milano, 20122 Milan, Italy.

Classifications MeSH