EFFICACY OF PREOPERATIVE SINGLE DOSE ANTIBIOTIC IN PATIENTS UNDERGOING MESH REPAIR FOR INGUINAL HERNIA
AbstractBackground: Inguinal hernia is the commonest type of external hernias. Lichtenstein mesh repair is the most favoured technique of inguinal hernia repair nowadays. It is tension free repair of weakened inguinal wall using polypropylene mesh. The present study was conducted to determine the efficacy of single dose antibiotic with placebo on patients undergoing inguinal hernia mesh repair. Methods: This randomised controlled trial was carried out in the Department of General Surgery, Ayub Teaching Hospital, Abbottabad from January to December 2011. The study population included male patients presenting with primary unilateral inguinal hernia, above 18 years of age. Mesh repair was performed in all patients. The patients were randomly divided into two groups. Patients in group A were given a single dose of antibiotic before inguinal hernia mesh repair and patients in group B were given placebo before inguinal hernia mesh repair. Efficacy of antibiotic and placebo was accessed in terms of surgical site infections (SSIs). Results: A total of 166 cases of inguinal hernia mesh repair patients were recorded during the study period. A total of 83 patients were recruited in each group. Surgical site infection was found in 6 (7.2%) in Group B it was 15 (18.1%). The difference being statistically significant (p=0.036). Conclusion: Antibiotic prophylaxis is a preferred option for mesh plasty.Keywords: Inguinal hernia, Mesh repair, Antibiotics, Infection
Haq RA, Chaudry IA, Khan BI, Afzal M. Groin sepsis following Lichtenstein inguinal hernioplasty without antibiotics prophylaxis. Pak J Med Sci 2006;22(4):216–9.
Ahmad S, Mufti TS, Zaffar A, Akbar I. Conservative management of mesh site infection in ventral hernia repair. J Ayub Med Coll Abbottabad 2007;19(4):75–7.
Tejirian T, DiFronzo A, Haigh PI. Antibiotic prophylaxis for preventing wound infection after breast surgery: a systematic review and meta-analysis. J Am Coll Surg 2006;203:729–34.
Cunningham M, Bunn F, Handscomb K. Prophylactic antibiotics to prevent surgical site infection after breast cancer surgery. Cochrane Database Syst Rev 2006;(2):CD005360.
Charalambous C, Tryfonidis M, Swindell R. When should old therapies be abandoned? A modern look at old studies on topical ampicillin. J Infect 2004;47:203–9.
Aufenacker TJ, Koelemay MJ, Gouma DJ. 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.
Catarci M, Mancini S, Gentileschi P, Camplone C, Sileri P, Grassi GB, et al. Antibiotic prophylaxis in elective laparoscopic cholecystectomy. Lack of need or lack of evidence. Surg Endosc 2004;18:638–41.
National Nosocomial Infections Surveillance System. National Nosocomial Infections Surveillance (NNIS) System Report, data summary from January 1992 through June 2004, issued October 2004. Am J Infect Control 2005;32:470–85.
Marinopoulos SS, Dorman T, Ratanawongsa N, Wilson LM, Ashar BH, Magaziner JL, et al. Effectiveness of Continuing Medical Education. Evidence Report/Technology Assessment No. 149 (Prepared by the Johns Hopkins Evidence-based Practice Center, under Contract No. 290-02-0018.) AHRQ Publication No. 07-E006. Rockville, MD: Agency for Healthcare Research and Quality. January 2007. [Accessed 2011 Dec 24] Available at: www.ahrq.gov/downloads/pub/ evidence/ df/cme/cme.pdf.
EU Hernia Trialist Collabration. Repair of groin hernia with synthetic mesh: meta-analysis of randomized controlled trials. Ann Surg 2008;235:322–32.
Yin Y, Song T, Liao B, Luo Q, Zhou Z. Antibiotic prophylaxis in patients undergoing open mesh repair of inguinal hernia: A meta-analysis. Am Surg 2012;78:359–65.
Manuel FJ, Seco-Gil JL. Antibiotic prophylaxis for hernia repair (Cochrane Review). In: The Cochrane Library, Issue 2. Oxford: Update Software; 2008:125–31.
Othman I. Prospective randomized evaluation of prophylactic antibiotic usage in patients undergoing tension free inguinal hernioplasty. Hernia 2011;15:309–13.
Thakur L, Upadhyay S, Peters NJ, Saini N, Deodhar M. Prophylactic antibiotic usage in patients undergoing inguinal mesh hernioplasty: A clinical study. Ind J Surg 2010;72:240–2.
Ijaz A, Amer MS. Post operative wound infection; Prevention “the role of antibiotic prophylaxis in Lichtenstein. Professional Med J 2010;17:174–9.
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.
Journal of Ayub Medical College, Abbottabad is an OPEN ACCESS JOURNAL which means that all content is FREELY available without charge to all users whether registered with the journal or not. The work published by J Ayub Med Coll Abbottabad is licensed and distributed under the creative commons License CC BY ND Attribution-NoDerivs. Material printed in this journal is OPEN to access, and are FREE for use in academic and research work with proper citation. J Ayub Med Coll Abbottabad accepts only original material for publication with the understanding that except for abstracts, no part of the data has been published or will be submitted for publication elsewhere before appearing in J Ayub Med Coll Abbottabad. The Editorial Board of J Ayub Med Coll Abbottabad makes every effort to ensure the accuracy and authenticity of material printed in J Ayub Med Coll Abbottabad. However, conclusions and statements expressed are views of the authors and do not reflect the opinion/policy of J Ayub Med Coll Abbottabad or the Editorial Board.
USERS are allowed to read, download, copy, distribute, print, search, or link to the full texts of the articles, or use them for any other lawful purpose, without asking prior permission from the publisher or the author. This is in accordance with the BOAI definition of open access.
AUTHORS retain the rights of free downloading/unlimited e-print of full text and sharing/disseminating the article without any restriction, by any means including twitter, scholarly collaboration networks such as ResearchGate, Academia.eu, and social media sites such as Twitter, LinkedIn, Google Scholar and any other professional or academic networking site.