Effect of Cefazolin Prophylaxis on Postoperative Infections for Implants Removal Surgery of Ankle

Background and Objective: There is not sufficient proof for the potential advantageous effect of antibiotic prophylaxis on the surgical site infection rates during removal of orthopedic implants but a high rate of the surgical site infection rates are reported for implant removal surgeries than internal fixation and/or open reduction of fractures. The objective of the study was to evaluate the effect of cefazolin prophylaxis on the surgical site infection. Materials and Methods: Total 298 patients with implants removal surgeries had subjected to randomize into two groups of 149 each. Patients had received bolus 1 g of cefazolin (CN group) or normal saline (NS group) before surgeries. The incidences of deep and superficial surgical site infection, health-related quality of life, functional outcome, visual analog scale, clinical and bacteriological assessments within 1 month after surgery were evaluated. Mann-Whitney test following Turkey post hoc tests were used for the surgical site infection at 95% of confidence level. Results: CN and NS groups had reported 19 (13%) and 21 (14%) superficial surgical site infection and 2 (1%) and 8 (5%) deep surgical site infection within 1 month, respectively. Both groups did not show a significant improvement in health-related quality of life, functional outcome and pain during 1 month. There were 12 (67%) microorganisms' species found sensitive and 6 (33%) found not sensitive to cefazolin in bacteriological assessments. Conclusion: Single dose of 1 g of cefazolin prophylaxis reduced numbers of patients with the surgical site infection.