EVALUATING THE EFFICACY OF ANTIBIOTIC PROPHYLAXIS ON INFECTION OUTCOMES AND MICROBIAL PATTERNS IN DEGLOVING INJURIES RESULTING FROM ROAD TRAFFIC ACCIDENTS: A PROSPECTIVE STUDY AT A TERTIARY CARE INSTITUTION IN PAKISTAN

Abstract

Objectives: This study aimed to evaluate the impact of different antibiotic prophylaxis regimens (preoperative only vs. combined pre- and postoperative) on the severity and type of surgical site infections, as well as to identify the microbial pathogens associated with SSIs in patients with degloving injuries.

Methodology: This prospective cohort study was conducted at the Pakistan Ordnance Factories (POF) Hospital, Wah Cantt, from January 2023 to January 2025. A total of 69 adult surgical patients were enrolled and categorized into two groups based on antibiotic regimen: those receiving preoperative antibiotics only and those receiving both pre- and postoperative antibiotics. Demographic and clinical variables were collected from hospital records, including age, gender, comorbidities, smoking status, type and duration of surgery, wound contamination level, and microbial profile. SSI severity and type were recorded. Data were analyzed using IBM SPSS version 25. Descriptive statistics were used for frequencies and proportions, and associations were tested using chi-square analysis, with significance set at p < 0.05.

Results: Of the 69 patients, 85.5% were male, with 42.0% aged 41–60 years. Hypertension (44.9%) and diabetes mellitus (36.2%) were common comorbidities. Emergency surgeries accounted for 76.8% of cases. A significant association was found between antibiotic regimen and SSI severity (χ²(1) = 8.87, p = .00), with more severe SSIs in the combined prophylaxis group (100%) compared to the preoperative-only group (0%). No significant association was observed with SSI type (χ²(2) = 2.28, p = .31). Escherichia coli (83.3%) and Staphylococcus aureus (68.8%) predominated in the combined group, suggesting a link between extended prophylaxis and resistant pathogens.

Conclusion: This study highlights a significant link between the antibiotic prophylaxis regimen and SSI severity, though not SSI type. The high prevalence of gram-negative pathogens, particularly E. coli, underscores the need to adapt prophylactic protocols to local microbial trends. Implementing evidence-based antibiotic strategies that prioritize appropriate timing, spectrum, and patient-specific risk factors is essential for enhancing SSI prevention and reducing antimicrobial resistance.