An extensive review of the spinal and arthroplasty literature was undertaken to evaluate the effectiveness of local antibiotic irrigation during surgery. (18) The use of an antimicrobial agent to irrigate at the source of the infection seems logical. The former two have been well studied, however the literature on the therapeutic efficacy and safety of gentamicin irrigation is sparse. Mueller et al published a meta-analysis of evidence for the effect of intraoperative irrigation on SSI after open abdominal surgery, which compared irrigation with saline, povidone-iodine, or antibiotics with no irrigation. Retrosternal antibiotic irrigation was first reported in the 1960s [16, 17]. 5 Results: The actual 30-day patient survival rate is 90%, the 1-year survival rate is 80%, and the 4-year survival rate is 67%. However, acute wound infection presenting immediately after surgery must be differentiated from chronic or recurrent infection presenting months or years later. We retrospectively evaluated our use of dual antibiotic irrigation at the time of mesh placement during open ventral hernia repair (OVHR), demonstrating a significant reduction in SSI (16.5 vs 5.4%) using a combination of gentamicin and clindamycin irrigation when compared to saline alone. irrigation, is a commonly used antibiotic in orthopaedic practice. Certain experimental and clinical observations indicate that the local use of antibiotics may be more effective in some situations than their systemic administration. Despite multiple innovations in prosthetic surgery, including anti-infective device coatings, surgical techniques to limit exposing the wound to skin flora and washout protocols with copious intraoperative irrigation, infection remains a serious concern for the prosthetic urologist. high-dose, local antibiotic irrigation therapy, systemic antibiotic treatment, surgical debridement, and graft conservation in a prospectively studied series of 10 patients. Surgical Irrigation Irrigation of the surgical field is utilized to cleanse the wound bed prior to closure to promote healing. Guidelines on Antimicrobial Prophylaxis in Surgery, 1 as well as guidelines from IDSA and SIS.2,3 The guidelines are in-tended to provide practitioners with a standardized approach to the rational, safe, and effective use of antimicrobial agents for the prevention of surgical-site infections (SSIs) based on (19) However, adding antibiotics or other substances to the irrigant is a much-debated topic. Many reports have failed to make such a distinction, thus leading to contradictory results. Local antibiotic irrigation has been shown to result in a decrease in the prevalence of postoperative infection when used during peritoneal irrigation, biliary tract surgery, and obstetric procedures. that current published data are sufficient to support the elimination of antibiotic solutions for surgical irrigation; the avoidance of surfactants for surgical irrigation; and the use of sterile normal saline, sterile water, and 1 medical device containing a sterile 0.05% chlorhexidine gluconate solution followed by … 4 Use of topical antibiotic irrigation of orthopedic wounds is also common to prevent infection. The objective of this study was to assess systemic absorption of gentamicin irrigation in joint replacement surgery. 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