Antibiotic prophylaxis for prevention of postoperative wound infection in adults undergoing open elective inguinal or femoral hernia repair

Orelio, Claudia; Hessen, C V van; Sánchez-Manuel, Francisco Javier; Aufenacker, T. J.; Scholten, R. J. P. M.

doi:10.1002/14651858.cd003769.pub5

Cited by 33 publications

(41 citation statements)

References 78 publications

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“…Mesh infections are the most serious cases, which usually call for excision of the mesh. [ 2 ] Some assessment tools are needed to predict SSI preoperatively in the hope of alleviating the occurrence and severity of SSI.…”

Section: Introductionmentioning

confidence: 99%

Pre-surgical peripheral blood inflammation markers predict surgical site infection following mesh repair of groin hernia

Zhuo¹,

D²,

Chen

et al. 2021

Medicine

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Surgical site infection (SSI) is a costly postoperative complication with a decrease in the quality of life. We aimed to probe the predictive role of peripheral blood inflammation markers for SSI following mesh repair of groin hernia (GH). This retrospective study assessed the data of 1177 patients undergoing elective mesh repair of GH (open/laparoscopy) in the absence of antibiotic prophylaxis. The relation between demographics, surgical factors, pre-surgical laboratory results and the occurrence of SSI were investigated by univariate and multivariate analyses. Receiver operating characteristic analysis was performed to determine the optimal threshold of parameters and compare their veracity. The overall SSI rate was 3.2% with 1-year follow-up (38 superficial and 1 deep SSI). Patients with SSI had significant higher pre-surgical neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) than those without ( P = .029 and P = .045, respectively); their NLR and PLR correlated positively with postoperative total days of antibiotic treatment for SSI (r = .689, P = .000; r = .493, P = .001; respectively). NLR and PLR had larger areas under the receiver operating characteristics curves than neutrophil (.875 vs. .601; P = .000; .726 vs. .601; P = .017). The combination of PLR and neutrophil/NLR raised the predictive sensitivity of PLR for SSI (sensitivity: PLR: 74.36%; PLR + neutrophil: 82.05%; PLR + NLR: 83.57%). On multivariate analyses, higher preoperative NLR (cut-off 2.44) and PLR (cut-off 125.42) were independent predictors for SSI. Higher pre-surgical NLR and PLR may be valuable predictors for SSI following elective mesh repair of GH.

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Section: Introductionmentioning

confidence: 99%

Pre-surgical peripheral blood inflammation markers predict surgical site infection following mesh repair of groin hernia

Zhuo¹,

D²,

Chen

et al. 2021

Medicine

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“… 9 The risk of an inguinal hernia mesh infection following elective surgery is less than 1%. 20 Inguinal hernias electively repaired with mesh have a recurrence rate 1–3% over 5 years. 21 In clean/contaminated operations, infection risk theoretically increases, although this relative risk increase was not observed in multiple large studies.…”

Section: Discussionmentioning

confidence: 99%

A Strangulated Meckel’s Diverticulum in an Inguinal Hernia: A Case Report and Literature Review

Holden¹,

Helewa²,

Hochman³

et al. 2021

IMCRJ

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Background Meckel’s diverticulum is an embryologic remnant of the vitelline duct, occurring in approximately 2% of the adult population. A hernia containing a Meckel’s diverticulum is called a Littré’s hernia and is rarely reported in the medical literature. Clinically, a Littré’s hernia is indistinguishable from a hernia containing small bowel and is often discovered incidentally during a repair. Case Presentation Herein, we report a rare case of strangulated Littré’s hernia in a patient’s right groin. The sac contained a long segment of small bowel in addition to a large Meckel’s diverticulum. The bowel was irreducible through the groin incision, and a lower midline laparotomy was made. Necrotic bowel including the Meckel’s diverticulum was resected. Given the presence of necrotic bowel and potential for infection, the hernia was repaired with a Bassini herniorrhaphy, reinforced with absorbable mesh. The patient recovered uneventfully. Conclusion Littré’s hernia is a rare clinical entity. Treatment is similar to any bowel-containing hernia. Repair of the hernia defect with permanent mesh should be weighed against the risk of implant infection.

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“…Although the application of synthetic mesh may cause an increased risk of complicated wound infections, synthetic mesh infections and erosions, 11 recommended perioperative management does not include standard perioperative antibiotic use. 12 Standard local antiseptics application decreases the number of bacteria adhering to the biomaterial applied, 13 and ameliorates scar appearance following abdominoplasty. 14 In case of our patient, successful surgical treatment involves not only radical tumour resection and hernia prevention but also adequate wound closure ensuring satisfactory cosmetic results, which was most challenging.…”

Section: Discussionmentioning

confidence: 99%

Caesarean Scar Endometriosis May Require Abdominoplasty

Barczyński

Sobstyl

Frąszczak

et al. 2021

Clin Med Insights Case Rep

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Endometriosis is defined as an ectopic presence of endometrium-like tissue outside uterine cavity, which most commonly involves intraperitoneal organs. However, one of the less frequent forms of the disease is abdominal wall endometriosis usually developing in surgical scars following obstetric and gynaecological surgeries involving uterine cavity entering, that is, caesarean section, myomectomy or hysterectomy. In this case report we present a case of a patient with extensive caesarean scar endometriosis, who required complex surgical management. Successful surgical treatment involved not only radical tumour resection and application of mesh in postoperative hernia prevention but also adequate wound closure ensuring satisfactory cosmetic results, which was most challenging. The abdominal wall defect could not be sutured by traditional technique, thus polypropylene mesh was used and partial abdominoplasty was performed. The wound healed without complication and 24-month follow-up showed no evidence of local recurrence and satisfactory cosmetic result. In case of extensive endometrial abdominal wall tumours surgical treatment may involve application of advanced plastic surgery techniques, like abdominoplasty or skin/musculocutaneous flaps transposition.

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Antibiotic prophylaxis for prevention of postoperative wound infection in adults undergoing open elective inguinal or femoral hernia repair

Cited by 33 publications

References 78 publications

Pre-surgical peripheral blood inflammation markers predict surgical site infection following mesh repair of groin hernia

Pre-surgical peripheral blood inflammation markers predict surgical site infection following mesh repair of groin hernia

A Strangulated Meckel’s Diverticulum in an Inguinal Hernia: A Case Report and Literature Review

Caesarean Scar Endometriosis May Require Abdominoplasty

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