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Fulltext Surgical antibiotic prophylaxis: incidence and risk of surgical site infection

Fadzwani B, Raha A.R, Nadia M.N, Wan Rahiza WM, Razman J, Nordiah A.J

IIUM Medical Journal Malaysia, 2020;19(1):45-53.
MyJurnal

Introduction: This prospective cross sectional study assessed surgical antibiotic prophylaxis (SAP) practice,
the incidence of surgical site infection (SSI) and its associated risks in Universiti Kebangsaan Malaysia Medical
Centre. Methods: Patients for elective colorectal, hepatobiliary, upper gastrointestinal, breast and
endocrine surgery, who received SAP were included and followed up until day-30 postoperatively. Types of
antibiotic, preoperative–dose timing, intraoperative re-dosing and its duration were recorded. The incidence
of SSI was calculated and its associated risks expressed in odds ratio. Results: Out of 166 patients recruited,
121 (72.89%) patients received SAP preoperatively, and 91 (75.21%) of them were prescribed the appropriate
antibiotic as per our institutional guideline. Three patients who continued to receive therapeutic antibiotic
postoperatively were excluded from statistical analysis. Eleven (9.10%) patients received SAP beyond the
preoperative–dose timing of 60 minutes (p=0.001), which was an independent risk factor for SSI (adjusted OR
4.527, 95% CI; 1.058-19.367, p=0.042). The risk of SSI also remained in patients who continued to receive
SAP beyond 24 hours (OR 4.667, 95% CI; 1.527-14.259, p=0.007). The overall rate of SSI was 17.18%.
Conclusion: We found that the choice of antibiotic prescribed for SAP was in accordance to institutional
guideline and the relatively high SSI incidence was similar to a recent local report. Although the number of
patients receiving preoperative dose-timing of > 60 minutes was low, it was nonetheless an independent risk
factor for SSI. The postoperative continuation of SAP for more than 24 hours showed no benefit in reducing
SSI.
Fulltext Surgical antibiotic prophylaxis: incidence and risk of surgical site infection.

Fadzwani B., Raha A.R., Nadia M.N., Wan Rahiza WM., Razman J., Nordiah A.J

IIUM Medical Journal Malaysia, 2020;19(1):45-53.
MyJurnal

This prospective cross sectional studyassessed surgical antibiotic prophylaxis (SAP) practice, the incidence of surgical site infection (SSI) and its associated risks in Universiti Kebangsaan Malaysia Medical Centre. Methods: Patients for elective colorectal, hepatobiliary, upper gastrointestinal, breast and endocrine surgery, who received SAP were includedand followed up until day-30 postoperatively. Types of antibiotic, preoperative–dose timing, intraoperative re-dosing and its duration were recorded. The incidence of SSI was calculated and its associated risks expressed in odds ratio.Results: Out of 166 patients recruited, 121 (72.89%) patients received SAP preoperatively, and 91 (75.21%) of them were prescribed the appropriate antibiotic as per our institutional guideline. Three patients who continued to receive therapeutic antibiotic postoperatively were excluded from statistical analysis. Eleven (9.10%) patients received SAP beyond the preoperative–dose timing of 60 minutes (p=0.001), which was an independent risk factor for SSI (adjusted OR 4.527, 95% CI; 1.058-19.367, p=0.042). The risk of SSI also remained in patients who continued to receive SAP beyond 24 hours (OR 4.667, 95% CI; 1.527-14.259, p=0.007). The overall rate of SSI was 17.18%. Conclusion:We found that the choice of antibiotic prescribed for SAP was in accordance to institutional guideline and the relatively high SSI incidence was similar to a recent local report. Although the number of patients receiving preoperative dose-timing of > 60 minutes was low, it was nonetheless an independent risk factor for SSI. The postoperative continuation of SAP for more than 24 hours showed no benefit in reducing SSI.
Effect of transcutaneous electrical acupoint stimulation in heart rate variability in post-on-call trainees

Low HJ, Cheah OK, Ng BH, Siti Nidzwani MM, Wan Rahiza WM, Liu CY

Med J Malaysia, 2024 Nov;79(6):764-769.
PMID: 39614796

INTRODUCTION: Anaesthesiology is a high-demand speciality with 24-hour on-call shifts, which can lead to significant stress and impaired sleep quality among anaesthetists. Nonpharmacological interventions like acupuncture have been widely explored for stress relief. This study aims to evaluate the impact of transcutaneous electrical acupoint stimulation (TEAS) on physiological parameters, specifically heart rate variability (HRV) and sleep quality, in anaesthesiology trainees following 24-hour on-call duty.
MATERIALS AND METHODS: A total of 38 anaesthesiology trainees, following 24-hour ICU on-call shifts, were recruited for this single-centre cross-sectional clinical trial. The participants were required to complete two 24-hour on-call duties. Demographic data and baseline sleep quality assessments were collected following the first on-call duty. Upon completion of the second on-call shift, participants underwent 20 minutes of TEAS at bilateral PC6 (Neiguan), LI4 (Hegu), LR3 (Taichong), and ST41 (Jiexi) points. Heart rate variability (HRV) parameters, blood pressure, and heart rate were recorded before and after TEAS. Post-TEAS sleep quality was assessed following an overnight rest.
RESULTS: The results demonstrated a significant reduction in systolic blood pressure compared to baseline (109.5±8.9 vs 111.9±10.1 mmHg, p = 0.006), as well as a significant decrease in diastolic blood pressure (69.3±8.0 vs 70.9±9.0 mmHg, p = 0.037) and heart rate (65.8±9.2 vs 67.4±9.8 bpm, p = 0.034). There was significant improvement in all aspects of sleep quality (p < 0.001). However, no statistically significant changes were observed in heart rate variability (HRV) parameters, including high-frequency (HF) power, lowfrequency (LF) power, and the LF/HF ratio.
CONCLUSION: TEAS may offer potential benefits in managing cardiovascular stress and improving sleep quality in highstress environments, such as post-call recovery. Nevertheless, its impact on autonomic nervous system regulation, as reflected by HRV, appears limited.

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