Postoperative Antibiotics After Thyroid Surgeries

Anum Iftikhar, Zahid Mehmood, Muhammad Naseem Baloch, Hammar Shahid, Saad Abdul Razzak, Syed Muhammad Shafqatullah

Abstract

Objective

To assess the effectiveness of antibiotic in elective thyroid surgeries at a tertiary care centre.

Study design

Experimental study.

Place & Duration of study

Department of General and Endocrine Surgery-Ward 25, Jinnah Postgraduate Medical Centre Karachi, from June 2018 to June 2019.

Methodology

All patients undergoing thyroid surgeries were included in this study. Patients were randomly divided into two groups, Group A received postoperative antibiotics and the group B acted as control. Oral tablet amoxicillin (875gm) + clavulanic acid (125gm) was given twice daily for three days in postoperative period. Patients were called for follow ups on 4th, 7th and 14th postoperative days and their wounds were assessed and graded according to South Hampton system of Wound Grading. Patients undergoing re-do thyroid surgeries, thyroid surgeries with modified radical neck dissection and patients with pre-existing infections were excluded from this study. Written and informed consent was taken from the patients and data was recorded on a pre-designed form.

Results

Eighty patients were included in this study. Out of these, 25% (n=20) underwent unilateral lobectomy, 73.75% (n=59) underwent total thyroidectomy, and 1 patient underwent Sistrunk’s procedure. Drain was placed in all patients. Among these, 50% (n=40) patients (group A) were given antibiotics and 50% (n= 40) patients (group B) did not receive that. From group A, 57.5% (n=23) showed normal healing (Grade 0) on 4th postoperative day and from group B, 55% (n=22). From group A 42.5% (n=17) showed mild erythema around wound (Grade I) on 4th postoperative day while 45% (n=18) from group B had same findings. From group A, 70% (n=28) patients had normally healed wounds on 7th postoperative day and from group B, 75% (n=30) had well healed wounds. On 14th postoperative day, 7.5% (n=3) and 2.5% (n=1) showed mild erythema around wound (Grade I) from group A and group B respectively. Grade II, grade III, grade IV and grade V wound infection were not seen in any patient.

Conclusion

Postoperative antibiotic is not needed in patients undergoing elective thyroid surgery.

Key words

Surgical site infections (SSIs), Postoperative antibiotics, Clean surgery, Antibiotic prophylaxis.