Evaluation of administration of prophylactic antibiotics in mesh repair of inguinal hernia

Authors

  • Mukesh Kumar Maheshwari Department of Surgery, Swami Vivekanand Subharti University, Meerut, Uttar Pradesh, India
  • Rahil Singh Department of Surgery, Swami Vivekanand Subharti University, Meerut, Uttar Pradesh, India
  • Surabhi Gupta Department of Pharmacology, Swami Vivekanand Subharti University, Meerut, Uttar Pradesh, India

DOI:

https://doi.org/10.18203/2349-2902.isj20191550

Keywords:

Hernia, Inguinal, Mesh, Prophylactic, Antibiotic

Abstract

Background: The benefit of use of prophylactic antibiotic in mesh inguinal hernia repair needs evaluation in view of emergence of resistant micro-organisms with indiscriminate use of antibiotics and also to avoid unnecessary expenditure.

Methods: 100 patients of primary inguinal hernia, fulfilling inclusion criteria, were recruited in a prospective, randomized, double blind study where single dose of prophylactic antibiotic half hour prior to mesh repair surgery was administered to 50 patients in study group and routine antibiotics to remaining 50 in control group. Follow up was done for any evidence of infection till one month after the surgery.

Results: The incidence of infection in both the groups was analyzed. Prophylactic antibiotic group reported to have an infection rate of 12% as compared to 10% in control group Incidence of infection in both groups was 2% at time of discharge and 0% after one week, at the time of suture removal. Two week after discharge 6% in study and 4% in control groups had infection. After one month of surgery, incidence of infection was 4% in both prophylactic antibiotic group and control group. None of the patients required mesh removal and results was statistically similar in both groups.

Conclusions: The use of prophylactic antibiotic in our study was seen to be as effective as routine preoperative and postoperative antibiotics and should be recommended as it reduces the cost burden to the patient significantly and also prevents development of bacterial resistance to drugs.

Metrics

Metrics Loading ...

References

Shirah BH, Shirah HA. Lichtenstein mesh hernioplasty for inguinal hernias: simplicity is the ultimate sophistication. Int Surg J. 2016;3(1):230-6.

Chow A, Purkatyastha S, Athanasiou T, Tekkis P, Darzi A. Inguinal hernia. BMJ Clin Evid. 2007;4:1-20.

O’Dwyer PJ, Norrie J, Alani A, Walker A, Duffy F, Horgan P. Observation or operation for patients with an asymptomatic inguinal hernia. Ann Surg. 2006;244:167-73.

Nordin P, Zetterstrom H, Carlsson P, Nilsson E. Cost-effectiveness analysis of local, regional and general anaesthesia for inguinal hernia repair using data from a randomized trial. Br J Surg. 2007;94:500-5.

Agarwal BB, Agarwal KA, Mahajan KC. Prospective double-blind randomized controlled study comparing heavy- and lightweight polypropylene mesh in totally extraperitoneal repair of inguinal hernia: early results. Surg Endosc. 2009;23:242-7.

Razack A, Kapoor KK, Tambat RM. The Role Of Single Dose Antibiotic Prophylaxis In Open Mesh Repair Of Inguinal Hernia: A Prospective, Double Blind Randomized Trial. J Evol Med Dental Sci. 2015;1(4):6017-26.

Aufenacker TJ, Koelemay MJW, Gouma DJ, Simons MP. 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. 2006;93:5-10.

Erdas E, Medas F, Pisano G, Nicolosi A, Calò PG. Antibiotic prophylaxis for open mesh repair of groin hernia: systematic review and meta-analysis. Hernia. 2016;20(6):765-76.

Stephenson BM. Complications of open groin hernia repairs. Surgical Clinics of North America. 2003;83(5):1255-78.

Li JF, Lai DD, Zhang XD, Sun KX, Luo HG. Meta-analysis of the effectiveness of prophylactic antibiotics in the prevention of postoperative complications after tension-free hernioplasty. Canadian J Surg. 2012;55(1):27.

Gaynes RP, Culver DH, Horan TC, Edwards JR, Richards C, Tolson JS, National Nosocomial Infections Surveillance System. Surgical site infection (SSI) rates in the United States, 1992–1998: the National Nosocomial Infections Surveillance System basic SSI risk index. Clin Infect Dis. 2001;33(Suppl 2):S69-77.

Yerdel MA, Akin EB, Dolalan S, Turkcapar AG, Pehlivan M, Gecim IE, et al. 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. 2001;233(1):26-33.

Sanchez-Manuel FJ, Lozano-Garcia J, Seco-Gil JL. Antibiotic prophylaxis for hernia repair. Cochrane Database Syst Rev. Cochrane Database Syst Rev. 2007;3:CD003769.

Sanchez‐Manuel FJ, Lozano‐García J, Seco‐Gil JL. Antibiotic prophylaxis for hernia repair. Cochrane Library (Updated). 2012;2:CD003769.

Vinoth N, Karthikeyan CR, Parmar H. Role of antibiotic prophylaxis in open inguinal hernioplasty–A prospective randomized clinical trial. Int Arch Integrated Med. 2015;2(3):57-67.

Iftikhar M, Irfan-ul-Islam Nasir RA, Aman Z. Prophylaxis of surgical site infection after mesh repair of inguinal hernia. Kjms. 2014;7(1):115.

Tzovaras G, Delikoukos S, Christodoulides G, Spyridakis M, Mantzos F, Tepetes K, et al. The role of antibiotic prophylaxis in elective tension‐free mesh inguinal hernia repair: results of a single‐centre prospective randomized trial. Int J Clin Pract. 2007;61(2):236-9.

Al-Fatah MA. The role of antibiotic prophylaxis in prevention of Wound infection after lichtenstein repair of primary inguinal hernia. AAMJ. 2011;9(1).

Ullah B, Khan SA, Ahmed S, Pasha T. Efficacy Of Preoperative Single Dose Antibiotic In Patients Undergoing Mesh Repair For Inguinal Hernia. J Ayub Med Coll Abbottabad. 2013;25(1-2):103-5.

Celdran A, Frieyro O, Pinta JC, Souto JL, Esteban J, Rubio JM, et al. The role of antibiotic prophylaxis on wound infection and mesh hernia repair under local anaesthesia on an ambulatory basis. Hernia. 2004;8(1):20‐2.

Usang UE, Sowande OA, Adejuyigbe O, Bakare TI, Ademuyiwa OA. The role of preoperative antibiotics in the prevention of wound infection after day case surgery for inguinal hernia in children in Ile Ife, Nigeria Pediatr Surg Int. 2008;24(10):1181-5.

Perez AR, Roxas MF, Hilvano SS. A randomized, double‐blind, placebo‐controlled trial to determine effectiveness of antibiotic prophylaxis for tension‐free mesh herniorraphy. J Am Coll Surg. 2005;200(3):393‐7.

Ergul Z, Akinci M, Urgulu C, Kulacoglu H, Yilmaz KB. Prophylactic antibiotic use in elective inguinal in a trauma centre. Hernia. 2012;16(2):145-51.

Shankar VG, Srinivasan K, Sistla SC, Jagdish S. Prophylactic antibiotics in open mesh repair of inguinal hernia. A randomized controlled trial. Int J Surg. 2010;8(6):444‐7.

Othman I. Prospective randomized evaluation of prophylactic antibiotic usage in patients undergoing tension free inguinal hernioplasty. Hernia. 2011;15(3):309‐13.

Jain SK, Jayant M, Norbu C. The role of antibiotic prophylaxis in mesh repair of primary inguinal hernias using prolene hernia system: a randomized prospective double‐blind control trial. Tropical Doctor. 2008;38:80‐2.

Downloads

Published

2019-04-29

Issue

Section

Original Research Articles