An Evaluation of Surgical Prophylaxis Procedures in Turkey: A Multi-Center Point Prevalence Study

Yıl: 2016 Cilt: 48 Sayı: 1 Sayfa Aralığı: 24 - 28 Metin Dili: Türkçe İndeks Tarihi: 29-07-2022

An Evaluation of Surgical Prophylaxis Procedures in Turkey: A Multi-Center Point Prevalence Study

Öz:
Amaç: Bu çalışmanın amacı, ülkemizdeki cerrahi proflaksi uygulamalarının rehberlere uygunluğunun değerlendirilmesidir. Gereç ve Yöntem: Bu amaçla, 4 üniversite, 5 eğitim-araştırma ve 7 devlet hastanesini içine alan bir nokta prevalans çalışması yapılmıştır. Cerrahi proflaksideki uygunluğunun değerlendirilmesinde "Clinical Practice Guidelines for Antimicrobial Surgery (CPGAS) 2013" rehberi baz alınmıştır.Bulgular: Toplam 16 merkez çalışmaya katılmış olup, bu merkezlerdeki 166 operasyon değerlendirilmiştir. Bunların 161'inde (%96,9) cerrahi proflaksi amacıyla parenteral antibiyotik uygulanmıştır. Olguların 66'sında (%40,9) kullanılan antibiyotiğin türü, 47'sinde (%29,1) ise süresi uygunsuz bulunmuştur. Cerrahi proflakside uygunsuz kullanılan antibiyotikler olarak en çok; seftriakson, glikopeptidler ve aminoglikozitler dikkati çekmektedir. İkinci ve 3.basamak sağlık kuruluşları arasında antibiyotik seçimindeki uygunsuzluk açısından anlamlı bir fark görülmemiştir. Cerrahi uygulamaların yaklaşık yarısında proflaktik antibiyotiklerin süresi rehber önerileriyle uyumlu bulunmamış olmakla birlikte; istatistiksel olarak 3.basamak hastanelerinin lehine bir durum olduğu görülmüştür. Conclusion: Antibiotics are to a considerable extent used in a manner incompatible with guidelines even in tertiary hospitals in Turkey. It must not be forgotten that several pre-, intra- and postoperative factors can be involved in the development of surgical site infections (SSI), and antibiotics are not the only option available for preventing these. A significant improvement can be achieved in prophylaxis with close observation, educational activities, collaboration with the surgical team and increasing compliance with guidelines. All health institutions must establish and apply their own SP consensus accompanied by the guidelines in order to achieve success in SP
Anahtar Kelime:

Konular: Genel ve Dahili Tıp

Türkiye'deki Cerrahi Proflaksi Uygulamalarının Değerlendirilmesi: Çok Merkezli Bir Nokta Prevalans Çalışması

Öz:
Objective: The purpose of this study was to evaluate compliance with guidelines in surgical prophylaxis (SP) procedures in Turkey.Materials and Methods: A point prevalence study involving 4 university, 5 education and research and 7 public hospitals was performed assessing compliance with guidelines for antibiotic use in SP. Compliance was based on the "Clinical Practice Guidelines for Antimicrobial Surgery (CPGAS) 2013" guideline.Results: Sixteen centers were included in the study, with 166 operations performed at these being evaluated. Parenteral antibiotic for SP was applied in 161 (96.9%) of these. Type of antibiotic was inappropriate in 66 (40.9%) cases and duration of use in 47 (29.1%). The main antibiotics used inappropriately in SP were ceftriaxone, glycopeptides and aminoglycosides. No significant difference was observed between secondary and tertiary hospitals in terms of inappropriate selection. Duration of prophylaxis was also incompatible with guideline recommendations in approximately half of surgical procedures performed in both secondary and tertiary hospitals, however statistical significance was observed between institutions in favor of tertiary hospitals.Conclusion: Antibiotics are to a considerable extent used in a manner incompatible with guidelines even in tertiary hospitals in Turkey. It must not be forgotten that several pre-, intra- and postoperative factors can be involved in the development of surgical site infections (SSI), and antibiotics are not the only option available for preventing these. A significant improvement can be achieved in prophylaxis with close observation, educational activities, collaboration with the surgical team and increasing compliance with guidelines. All health institutions must establish and apply their own SP consensus accompanied by the guidelines in order to achieve success in SP
Anahtar Kelime:

Konular: Genel ve Dahili Tıp
Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık
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APA Kaya S, AKTAŞ S, ŞENBAYRAK S, Tekin R, ÖZTOPRAK N, AKSOY F, fırat p, YENİCE S, oncul a, Gunduz A, SOLAK S, Kadanalı A, CAKAR S, CAGLAYAN D, YILMAZ H, BOZKURT İ, ELMASLAR T, SAĞMAK TARTAR A, AYNİOĞLU A, KOCYİGİT N, Koksal I (2016). An Evaluation of Surgical Prophylaxis Procedures in Turkey: A Multi-Center Point Prevalence Study. , 24 - 28.
Chicago Kaya Selçuk,AKTAŞ Seyhan,ŞENBAYRAK Seniha,Tekin Recep,ÖZTOPRAK Nefise,AKSOY Firdevs,fırat pınar,YENİCE Sevinç,oncul ahsen,Gunduz Alper,SOLAK Semiha,Kadanalı Ayten,CAKAR Sule Eren,CAGLAYAN Derya,YILMAZ Hava,BOZKURT İlkay,ELMASLAR Tulin,SAĞMAK TARTAR AYŞE,AYNİOĞLU Aynur,KOCYİGİT Nilgun Fidan,Koksal Iftihar An Evaluation of Surgical Prophylaxis Procedures in Turkey: A Multi-Center Point Prevalence Study. (2016): 24 - 28.
MLA Kaya Selçuk,AKTAŞ Seyhan,ŞENBAYRAK Seniha,Tekin Recep,ÖZTOPRAK Nefise,AKSOY Firdevs,fırat pınar,YENİCE Sevinç,oncul ahsen,Gunduz Alper,SOLAK Semiha,Kadanalı Ayten,CAKAR Sule Eren,CAGLAYAN Derya,YILMAZ Hava,BOZKURT İlkay,ELMASLAR Tulin,SAĞMAK TARTAR AYŞE,AYNİOĞLU Aynur,KOCYİGİT Nilgun Fidan,Koksal Iftihar An Evaluation of Surgical Prophylaxis Procedures in Turkey: A Multi-Center Point Prevalence Study. , 2016, ss.24 - 28.
AMA Kaya S,AKTAŞ S,ŞENBAYRAK S,Tekin R,ÖZTOPRAK N,AKSOY F,fırat p,YENİCE S,oncul a,Gunduz A,SOLAK S,Kadanalı A,CAKAR S,CAGLAYAN D,YILMAZ H,BOZKURT İ,ELMASLAR T,SAĞMAK TARTAR A,AYNİOĞLU A,KOCYİGİT N,Koksal I An Evaluation of Surgical Prophylaxis Procedures in Turkey: A Multi-Center Point Prevalence Study. . 2016; 24 - 28.
Vancouver Kaya S,AKTAŞ S,ŞENBAYRAK S,Tekin R,ÖZTOPRAK N,AKSOY F,fırat p,YENİCE S,oncul a,Gunduz A,SOLAK S,Kadanalı A,CAKAR S,CAGLAYAN D,YILMAZ H,BOZKURT İ,ELMASLAR T,SAĞMAK TARTAR A,AYNİOĞLU A,KOCYİGİT N,Koksal I An Evaluation of Surgical Prophylaxis Procedures in Turkey: A Multi-Center Point Prevalence Study. . 2016; 24 - 28.
IEEE Kaya S,AKTAŞ S,ŞENBAYRAK S,Tekin R,ÖZTOPRAK N,AKSOY F,fırat p,YENİCE S,oncul a,Gunduz A,SOLAK S,Kadanalı A,CAKAR S,CAGLAYAN D,YILMAZ H,BOZKURT İ,ELMASLAR T,SAĞMAK TARTAR A,AYNİOĞLU A,KOCYİGİT N,Koksal I "An Evaluation of Surgical Prophylaxis Procedures in Turkey: A Multi-Center Point Prevalence Study." , ss.24 - 28, 2016.
ISNAD Kaya, Selçuk vd. "An Evaluation of Surgical Prophylaxis Procedures in Turkey: A Multi-Center Point Prevalence Study". (2016), 24-28.
APA Kaya S, AKTAŞ S, ŞENBAYRAK S, Tekin R, ÖZTOPRAK N, AKSOY F, fırat p, YENİCE S, oncul a, Gunduz A, SOLAK S, Kadanalı A, CAKAR S, CAGLAYAN D, YILMAZ H, BOZKURT İ, ELMASLAR T, SAĞMAK TARTAR A, AYNİOĞLU A, KOCYİGİT N, Koksal I (2016). An Evaluation of Surgical Prophylaxis Procedures in Turkey: A Multi-Center Point Prevalence Study. Eurasian Journal of Medicine, 48(1), 24 - 28.
Chicago Kaya Selçuk,AKTAŞ Seyhan,ŞENBAYRAK Seniha,Tekin Recep,ÖZTOPRAK Nefise,AKSOY Firdevs,fırat pınar,YENİCE Sevinç,oncul ahsen,Gunduz Alper,SOLAK Semiha,Kadanalı Ayten,CAKAR Sule Eren,CAGLAYAN Derya,YILMAZ Hava,BOZKURT İlkay,ELMASLAR Tulin,SAĞMAK TARTAR AYŞE,AYNİOĞLU Aynur,KOCYİGİT Nilgun Fidan,Koksal Iftihar An Evaluation of Surgical Prophylaxis Procedures in Turkey: A Multi-Center Point Prevalence Study. Eurasian Journal of Medicine 48, no.1 (2016): 24 - 28.
MLA Kaya Selçuk,AKTAŞ Seyhan,ŞENBAYRAK Seniha,Tekin Recep,ÖZTOPRAK Nefise,AKSOY Firdevs,fırat pınar,YENİCE Sevinç,oncul ahsen,Gunduz Alper,SOLAK Semiha,Kadanalı Ayten,CAKAR Sule Eren,CAGLAYAN Derya,YILMAZ Hava,BOZKURT İlkay,ELMASLAR Tulin,SAĞMAK TARTAR AYŞE,AYNİOĞLU Aynur,KOCYİGİT Nilgun Fidan,Koksal Iftihar An Evaluation of Surgical Prophylaxis Procedures in Turkey: A Multi-Center Point Prevalence Study. Eurasian Journal of Medicine, vol.48, no.1, 2016, ss.24 - 28.
AMA Kaya S,AKTAŞ S,ŞENBAYRAK S,Tekin R,ÖZTOPRAK N,AKSOY F,fırat p,YENİCE S,oncul a,Gunduz A,SOLAK S,Kadanalı A,CAKAR S,CAGLAYAN D,YILMAZ H,BOZKURT İ,ELMASLAR T,SAĞMAK TARTAR A,AYNİOĞLU A,KOCYİGİT N,Koksal I An Evaluation of Surgical Prophylaxis Procedures in Turkey: A Multi-Center Point Prevalence Study. Eurasian Journal of Medicine. 2016; 48(1): 24 - 28.
Vancouver Kaya S,AKTAŞ S,ŞENBAYRAK S,Tekin R,ÖZTOPRAK N,AKSOY F,fırat p,YENİCE S,oncul a,Gunduz A,SOLAK S,Kadanalı A,CAKAR S,CAGLAYAN D,YILMAZ H,BOZKURT İ,ELMASLAR T,SAĞMAK TARTAR A,AYNİOĞLU A,KOCYİGİT N,Koksal I An Evaluation of Surgical Prophylaxis Procedures in Turkey: A Multi-Center Point Prevalence Study. Eurasian Journal of Medicine. 2016; 48(1): 24 - 28.
IEEE Kaya S,AKTAŞ S,ŞENBAYRAK S,Tekin R,ÖZTOPRAK N,AKSOY F,fırat p,YENİCE S,oncul a,Gunduz A,SOLAK S,Kadanalı A,CAKAR S,CAGLAYAN D,YILMAZ H,BOZKURT İ,ELMASLAR T,SAĞMAK TARTAR A,AYNİOĞLU A,KOCYİGİT N,Koksal I "An Evaluation of Surgical Prophylaxis Procedures in Turkey: A Multi-Center Point Prevalence Study." Eurasian Journal of Medicine, 48, ss.24 - 28, 2016.
ISNAD Kaya, Selçuk vd. "An Evaluation of Surgical Prophylaxis Procedures in Turkey: A Multi-Center Point Prevalence Study". Eurasian Journal of Medicine 48/1 (2016), 24-28.