Hannah is a Foundation Year 2 Doctor with a keen interest in vascular surgery. She has research interests in surgical site infections and reducing our environmental carbon  footprint.

Presentation at The Society of Tissue Viability 2025 Conference

Targeted antibiotic prophylaxis for prevention of SSI

Objectives

The presentation is aimed at:

• All healthare professionals

Delegates will learn about:

• The importance of working as an MDT
• How antimicrobial stewardship can impact SSI

Abstract

Introduction: Surgical Site Infections(SSI) complicate up to 40% of lower limb vascular surgery​​. ​​​​​​The aim of this study was to investigate if targeting antibiotic prophylaxis to the surgical site and local resistance patterns reduced the rate of SSI.

Methods: This pre-post cohort study recruited adult patients undergoing lower limb vascular surgery. Cohort 1 (the pre-change group) consisted of patients receiving generic antibiotic prophylaxis and cohort 2 (the post-change group) received targeted antibiotic prophylaxis. The primary outcome was SSI at 30 days post-surgery, defined by CDC criteria/ASEPSIS scores.

Results: Of the 191 participants recruited to the study, 171 were included in data analysis. There were 48 (28.1%) infections recorded overall. In Cohort 1 there were 30/75(40.0%) infections and 18/96(18.8%) in cohort 2, resulting in an absolute risk reduction of 21.2%(p=0.002).  The odds ratio logistic regression noted two variables were statistically significant in regards to incidence of SSI, antibiotic type (p=0.017) and BMI (p=0.009). The results showed with targeted antibiotic prophylaxis (cohort 2) you were three times less likely to get a SSI compared to cohort 1 (OR, 0.346; 95% CI, 0.174-0.690).

Conclusion: Targeted antibiotic prophylaxis significantly reduced SSI rates in this high-risk patient group. Vascular departments should work collaboratively with infectious disease teams to utilise targeted prophylaxis regimes based upon local antimicrobial resistance profiles.