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TO USE or not use prophylactic antibiotics for operations in a clean field continues to be debatable. Postoperative wound infection occurs either through imperfect sterilization techniques or by precipitation of air-bone bacteria on the open wound. The larger the wound and the longer it is exposed, the greater the chance of air-bone contamination. In the field of otolaryngology, radical neck dissection and translabyrinthine removal of acoustic neuromas require relatively large surgical exposures for a relatively long time.
Experimental studies on animals (Surgery50:151, 1961) have demonstrated that the prevention of multiplication of organisms in wound tissues is greatest when antibiotics are given before wound contamination and during the first three hours after bacteria enter the tissues. Accordingly, antibiotics effective against the usual wound contaminants should be administered shortly before, during, and immediately after the operation.
Two recent clinical studies on prophylactic antibiotics have given contradictory results. In 1964 Bernard
SHAMBAUGH GE. Prophylactic Antibiotics. Arch Otolaryngol. 1966;84(6):597. doi:10.1001/archotol.1966.00760030599001
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