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Surgical site infections (SSIs) remain one of the most confounding issues of the surgeons, despite the numerous revolutions in the field of surgical technique, asepsis and antisepsis in the historical process and current technologies.1 Although the development of effective antibiotics which are easily applied in clinical practice with the concept of antimicrobial prophylaxis (AMP), the incidence of SSI is reported to reach 20% depending on many patients and disease-related factors.2 This situation is no different for stomach cancer surgery, which is one of the most major intaabdominal surgeries, and the incidence of SSI was found to be between 5% and 20%.3 AMP is widely applied before many surgical procedures, and studies have shown that it effectively prevents SSI depending on the distribution of patients, the effectiveness of the antibiotic used, and the surgical procedure performed.4,5 Although it has been clarified which antibiotic will be used in which surgical procedure and the effective doses of the antibiotics used, the evidence on the duration of AMP is limited. Although it has been concluded that single dose AMP is sufficient in colorectal and hepatobiliary surgery, a clear consensus has not been achieved, except for a few randomized studies that advocate the same idea with limited evidence in gastric cancer surgery.6-10 While single-dose AMP prior to gastric cancer surgery was the common concept in the West, it was shown in a survey on surgeons in the Far East that more than 60% of surgeons continued prophylaxis in the postoperative period.11 Based on the limited number of studies and clinical experience, there are no clear data on the duration of antibiotic use, although the single-dose AMP is considered to be more advantageous than the extended-dose AMP because of the potential complications of extended-dose AMP such as drug side effects and bacterial resistance development. Therefore, in this study, we aimed to compare the effectiveness of single-dose and extended-dose AMP in preventing the development of SSIs in patients undergoing curative gastrectomy with the diagnosis of gastric cancer.

journal of contemporary medical sciences

The Comparison of Single-Dose and Extended-Dose Antimicrobial Prophylaxis for Preventing Surgical Site Infections After Curative Surgery for Gastric Adenocarcinoma