Comparative Study on the Efficacy of Postsurgical Oral Prophylactic Antibiotic Versus Antimicrobial Suture Placement Alo
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ORIGINAL ARTICLE
Comparative Study on the Efficacy of Postsurgical Oral Prophylactic Antibiotic Versus Antimicrobial Suture Placement Alone in Preventing Surgical Site Infection After Removal of Impacted Mandibular Third Molar Shama Mohan1 • B. S. Jayanth1 • Shruthi Saralaya1 • S. M. Sunil1 A. S. Mohamed Sageer1 • R. Harikrishnan1
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Received: 19 February 2019 / Accepted: 30 July 2019 The Association of Oral and Maxillofacial Surgeons of India 2019
Abstract Aim To evaluate the efficacy of postsurgical oral prophylactic antibiotic versus antimicrobial suture placement in preventing infection after removal of an impacted mandibular third molar. Materials and methods This was a prospective, singleblind study including 150 individuals of 18–40 years divided into two groups with 75 patients each. The patients in Group 1 were administered oral amoxicillin tablets 500 mg for 5 days postsurgery with 3–0 polyglactin sutures for closure and in group 2 with (3–0) antimicrobial chlorhexidine diacetate-impregnated polyglactin sutures only. Evaluation was done on 3rd, 7th, 15th days and 1 month. Results There was no significant difference in rates of infection between the groups. Abnormal erythema, pain and trismus showed statistically better results in group 2 on 3rd and 7th days. An antibiotic side effect assessment showed 17.65% patients with minor side effects. Conclusion Chlorhexidine diacetate-impregnated polyglactin sutures showed reduced erythema, pain and trismus in healthy patients undergoing surgical removal of third molar. Keywords Chlorhexidine diacetate-impregnated polyglactin suture Postsurgical antibiotic prophylaxis Infection Erythema Trismus Antibiotic side effect assessment
& Shama Mohan [email protected] 1
Department of Oral and Maxillofacial Surgery, Coorg Institute of Dental Sciences, Virajpet, Karnataka, India
Introduction The surgical removal of impacted third molars represents the keystone of oral and maxillofacial ambulatory procedures that are considered as clean-contaminated operations [1]. Numerous studies indicate that the incidence of postoperative infections following the surgical removal of third molar ranges from 1 to 5.8% and the routine use of antibiotics is not advised for the prevention of such a low incidence of serious infection [2]. The debate about the use of antibiotic prophylaxis began in the early 1950s following which Peterson, in his article, has precisely described these principles: (1) the surgical procedure should have a significant risk of infection; (2) the correct antibiotic should be selected for the surgical procedure; (3) the antibiotic level must be high; (4) the antibiotic should be administered in a correct time; (5) the shortest effective antibiotic exposure should be used [3]. The first principle sets the criterion for antibiotic usage, whereas principles 2–5 outline the protocol for administration of the antibiotic. If the routine use of antibiotics for third molar surgery is to be prescribed, principle 1 must be proved right. Antibiotic resistan
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