Skip to main content
Top
Published in: Hernia 3/2011

01-06-2011 | Original Article

Prospective randomized evaluation of prophylactic antibiotic usage in patients undergoing tension free inguinal hernioplasty

Author: I. Othman

Published in: Hernia | Issue 3/2011

Login to get access

Abstract

Objectives

Assessment of the usefulness of antibiotic prophylaxis in inguinal hernioplasty.

Materials and methods

This prospective randomized double blind study was conducted on 98 patients. Group A (50 patients) received a single dose of intravenous amoxicillin and clavulanic acid, and Group P (48 patients) received an equal volume of normal saline placebo by intravenous bolus 30 min before the induction of anesthesia. Hernioplasty was performed with polypropylene mesh. Skin was closed using skin staples that were removed after complete wound healing. The surgical site infection was diagnosed according to APIC, CDC criteria (http://​www.​apic.​org).

Results

The mean operative time was 38.8  ± 10.8 min in group A versus 40.9 ± 11.1 min in group P (P  = 0.34). The mean hospitalization time was 1.3 ± 0.463 days in group A versus 1.25 ± 0.438 days in group P (P = 0.58). Four patients (2%) in group A and 6 patients (2.88%) in group P had wound infections (P = 0.47). Group A had 3 superficial infections and 1 deep infection while group P had 5 superficial infections and 1 deep infection. Antibiotic treatment of the wound infection was successful in all patients. Wound culture showed Staphylococcus aureus infection in 1 patient each group, Streptococcus pyogenes in 1 group A patient and Pseudomonas aeruginosa in 1 group P patient. Cultures in other patients in both groups were reported to be sterile.

Conclusion

Prophylactic antibiotic usage in patients undergoing tension free inguinal hernioplasty did not show any statistically significant beneficial effects in reduction of surgical site infection.
Literature
1.
go back to reference Lichtenstein IL, Shulman AG, Amid PK, Montllor MM (1989) The tension-free hernioplasty. Am J Surg 157(2):188–193PubMedCrossRef Lichtenstein IL, Shulman AG, Amid PK, Montllor MM (1989) The tension-free hernioplasty. Am J Surg 157(2):188–193PubMedCrossRef
2.
go back to reference Burger JW, Luijendijk RW, Hop WC, Halm JA, Verdaasdonk EG, Jeekel J (2004) Long term follow-up of a randomized controlled trial of suture versus mesh repair of incisional hernia. Ann Surg 240:578–585PubMed Burger JW, Luijendijk RW, Hop WC, Halm JA, Verdaasdonk EG, Jeekel J (2004) Long term follow-up of a randomized controlled trial of suture versus mesh repair of incisional hernia. Ann Surg 240:578–585PubMed
3.
4.
go back to reference Barie PS (2000) Modern surgical antibiotic prophylaxis and therapy—less is more. Surg Infect (Larchmt) 1:23–29CrossRef Barie PS (2000) Modern surgical antibiotic prophylaxis and therapy—less is more. Surg Infect (Larchmt) 1:23–29CrossRef
5.
6.
go back to reference Cheek CM, Williams MH, Farndon JR (1995) Trusses in the management of hernia today. Br J Surg 82:1611–1613PubMedCrossRef Cheek CM, Williams MH, Farndon JR (1995) Trusses in the management of hernia today. Br J Surg 82:1611–1613PubMedCrossRef
7.
go back to reference Abo RE (1998) Perioperative antibiotic prophylaxis in abdominal surgery for hernia repair: retrospective study of 1,524 consecutive patients. J Chemother 10:248–253 Abo RE (1998) Perioperative antibiotic prophylaxis in abdominal surgery for hernia repair: retrospective study of 1,524 consecutive patients. J Chemother 10:248–253
8.
go back to reference Taylor EW, Duffy K, Lee K et al (2004) Surgical site infection after groin hernia repair. Br J Surg 91:105–111PubMedCrossRef Taylor EW, Duffy K, Lee K et al (2004) Surgical site infection after groin hernia repair. Br J Surg 91:105–111PubMedCrossRef
9.
go back to reference Deysine M (1998) Pathophysiology, prevention, and management of prosthetic infections in hernia surgery. Surg Clin North Am 78:1105–1115PubMedCrossRef Deysine M (1998) Pathophysiology, prevention, and management of prosthetic infections in hernia surgery. Surg Clin North Am 78:1105–1115PubMedCrossRef
10.
go back to reference Amid PK (1997) Classification of biomaterials and their related complications in abdominal wall hernia surgery. Hernia 1:15–21CrossRef Amid PK (1997) Classification of biomaterials and their related complications in abdominal wall hernia surgery. Hernia 1:15–21CrossRef
11.
go back to reference Perez AR, Roxas MF, Hilvano SS (2005) A randomized double blind, placebo controlled trial to determine effectiveness of antibiotic prophylaxis for tension free mesh hernioraphy. J Am Coll Surg 200:393–398PubMedCrossRef Perez AR, Roxas MF, Hilvano SS (2005) A randomized double blind, placebo controlled trial to determine effectiveness of antibiotic prophylaxis for tension free mesh hernioraphy. J Am Coll Surg 200:393–398PubMedCrossRef
12.
go back to reference Lee TB, Montgomer OG, Marx J, Olmsted RN, Scheckler WE (2007) Recommended practices for surveillance: association for Professionals in Infection Control and Epidemiology (APIC), Inc. Am J Infect Control 35(7):427–440PubMedCrossRef Lee TB, Montgomer OG, Marx J, Olmsted RN, Scheckler WE (2007) Recommended practices for surveillance: association for Professionals in Infection Control and Epidemiology (APIC), Inc. Am J Infect Control 35(7):427–440PubMedCrossRef
14.
go back to reference Patino JF, Garcia-Herreros LG, Zundel N (1998) Inguinal hernia repair: the Nyhus posterior preperitoneal operation. Surg Clin North Am 78:1063–1074PubMedCrossRef Patino JF, Garcia-Herreros LG, Zundel N (1998) Inguinal hernia repair: the Nyhus posterior preperitoneal operation. Surg Clin North Am 78:1063–1074PubMedCrossRef
15.
go back to reference Zuvela M, Milićević M, Galun D, Lekić N, Basarić D, Tomić D, Petrović M, Palibrk I (2005) Infection in hernia surgery. Acta Chir Iugosl 52(1):9–26PubMedCrossRef Zuvela M, Milićević M, Galun D, Lekić N, Basarić D, Tomić D, Petrović M, Palibrk I (2005) Infection in hernia surgery. Acta Chir Iugosl 52(1):9–26PubMedCrossRef
16.
go back to reference Yerdel MA, Akin EB, Dolalan S et al (2001) Effect of single dose prophylactic ampicillin and sulbactam on wound infection after tension-free inguinal hernia repair with polypropylene mesh: the randomized, double blind, prospective trial. Ann Surg 233:26–33PubMedCrossRef Yerdel MA, Akin EB, Dolalan S et al (2001) Effect of single dose prophylactic ampicillin and sulbactam on wound infection after tension-free inguinal hernia repair with polypropylene mesh: the randomized, double blind, prospective trial. Ann Surg 233:26–33PubMedCrossRef
17.
go back to reference Sanabria A, Dominguez LC, Valdivieso E, Gomez G (2007) Prophylactic antibiotic for mesh hernioplasty. A meta analysis. Ann Surg 245:392–396PubMedCrossRef Sanabria A, Dominguez LC, Valdivieso E, Gomez G (2007) Prophylactic antibiotic for mesh hernioplasty. A meta analysis. Ann Surg 245:392–396PubMedCrossRef
19.
go back to reference Tzovaras G, Delikoukos S, Christodoulides G, Spyridakis M, Mantzos F, Tepetes K et al (2006) The role of antibiotic prophylaxis in elective tension-free mesh inguinal hernia repair: results of a single-centre prospective randomised trial. Int J Clin Pract 6:236–239CrossRef Tzovaras G, Delikoukos S, Christodoulides G, Spyridakis M, Mantzos F, Tepetes K et al (2006) The role of antibiotic prophylaxis in elective tension-free mesh inguinal hernia repair: results of a single-centre prospective randomised trial. Int J Clin Pract 6:236–239CrossRef
20.
go back to reference Aufenacker TJ, Koelemay MJ, Gouma DJ, Simons MP (2006) Systematic review and meta-analysis of the effectiveness of antibiotic prophylaxis in prevention of wound infection after mesh repair of abdominal wall hernia. Br J Surg 93(1):5–10PubMedCrossRef Aufenacker TJ, Koelemay MJ, Gouma DJ, Simons MP (2006) Systematic review and meta-analysis of the effectiveness of antibiotic prophylaxis in prevention of wound infection after mesh repair of abdominal wall hernia. Br J Surg 93(1):5–10PubMedCrossRef
21.
go back to reference Platt R, Zaleznik DF, Hopkins CC, Dellinger EP, KarchmerAW Bryan CS et al (1990) Perioperative antibiotic prophylaxis for hernioraphy and breast surgery. N Engl J Med 322:153–160PubMedCrossRef Platt R, Zaleznik DF, Hopkins CC, Dellinger EP, KarchmerAW Bryan CS et al (1990) Perioperative antibiotic prophylaxis for hernioraphy and breast surgery. N Engl J Med 322:153–160PubMedCrossRef
22.
go back to reference Just E, Botet X, Martínez S, Escolà D, Moreno I, Duque E (2010) Reduction of the complication rate in Liechtenstein hernia repair. Int J Surg 8:462–465 Just E, Botet X, Martínez S, Escolà D, Moreno I, Duque E (2010) Reduction of the complication rate in Liechtenstein hernia repair. Int J Surg 8:462–465
23.
go back to reference Taylor SG, Dwyer PJO (1999) Chronic groin sepsis following tension free inguinal hernioplasty. Br J Surg 86:562–565PubMedCrossRef Taylor SG, Dwyer PJO (1999) Chronic groin sepsis following tension free inguinal hernioplasty. Br J Surg 86:562–565PubMedCrossRef
Metadata
Title
Prospective randomized evaluation of prophylactic antibiotic usage in patients undergoing tension free inguinal hernioplasty
Author
I. Othman
Publication date
01-06-2011
Publisher
Springer-Verlag
Published in
Hernia / Issue 3/2011
Print ISSN: 1265-4906
Electronic ISSN: 1248-9204
DOI
https://doi.org/10.1007/s10029-011-0783-3

Other articles of this Issue 3/2011

Hernia 3/2011 Go to the issue