Surgical prophylaxis for burns surgery

Surgical antibiotic prophylaxis is not indicated for the majority of patients with burns undergoing surgical debridement.

For patients with extensive burns, surgical antibiotic prophylaxis may be considered before aggressive surgical debridement; however, evidence to support the use of prophylaxis is limited. Antibiotic prophylaxis may also be considered before split-thickness skin graft procedures for extensive burns, particularly if the burn is heavily colonised with bacteria. Antibiotic prophylaxis is not indicated for patients with burns who do not require immediate debridement surgery.

If prophylaxis is prescribed, antibiotic choice should be guided by local epidemiology and the results of recent culture and susceptibility testing.

Postoperative administration of prophylactic antibiotics (intravenous, oral or topical) is not indicated.

Surgical antibiotic prophylaxis is not required if the patient is already receiving antibiotic therapy for established infection. However, adjust the timing of the treatment dose to achieve adequate plasma and tissue concentrations at the time of surgical incision and for the duration of the procedure—seek expert advice.