Does topical rifampicin reduce the risk of surgical field infection in hernia repair?

Abstract

Objective: Inguinal hernia operations are common procedures in general surgery. There have been many approaches in the historical development of hernia repair; tension free repair with mesh being the most commonly used technique today. Although it is a clean wound, antibiotic use is still controversial due to concerns about infection related to synthetic mesh. We aimed to determine the probable role of topical rifampicin in patients with tensionfree hernia repair and mesh support. Material and Methods:The charts of patients who underwent tension-free inguinal hernia repair were retrospectively analyzed. Information and operative notes on patients, in whom synthetic materials were used, were identified. The patients were divided into two groups, placebo group (G1) and patients with application of topical rifampicin on the mesh (G2). Infection rates between the groups in the early postoperative period were compared. Results:The mean age of the 278 patients who were included in the study was 49.6±15.39 and the female/male ratio was 10/268. There were recurrent hernias in four patients and superficial wound infections in 22 patients in the early period. One patient had testicle torsion and underwent an orchiectomy. There were no significant differences between the groups in terms of age and gender. The types of hernia and body mass index were homogenous between the two groups. In the early postoperative period the infection rates were 16/144 (11.1%) and 6/134 (4.48%) in the groups, respectively, with the difference being statistically significant (p=0.041). Conclusion:We suggest that applying rifampicin locally can decrease surgical site infection in hernia operations where meshes are used.

Thermo-Responsive Antimicrobial Hydrogel for the In-Situ Coating of Mesh Materials for Hernia Repair

“…The selected antibiotic, rifampicin, was previously reported as an adequate drug to reduce the risk of infection following hernia repair surgery, where the antibiotic was topically applied onto the implanted mesh [29]. In our study, we proved that the in-situ Rif-HApN coating is not cytotoxic and does not hamper the tissue integration of meshes implanted in the abdominal wall of rabbits.…”

Rifampin-Releasing Triple-Layer Cross-Linked Fresh Water Fish Collagen Sponges as Wound Dressings

“…When compared in vivo , the release of rifampin from the sponges was slower than that from the direct s. c. application of the rifampin solution ( Figure 12 ), and moreover, the sponges maintained systemic rifampin levels at above 0.2 mg/mL for at least 22 hours, which is a higher level than the MIC for streptococci and staphylococci according to the European Committee on Antimicrobial Susceptibility Testing database ( https://mic.eucast.org , cited in 01/2020). This was not attainable via the administration of a single dose of rifampin s. c. Rifampin concentrations are much higher in the location of absorption than in the systemic circulation, and rifampin has been proved to be effective in terms of postsurgical wound infection prevention when administered locally [ 5 ]. The sponges presented in this study have the potential to serve as ideal postoperative dressings following surgery in infection-susceptible areas including those colonized by methicillin-resistant staphylococcus aureus (MRSA).…”

“…Surgical wound infections constitute one of the most frequently occurring postsurgical complications and often lead to prolonged hospital stays, increased healthcare costs, and a deterioration in the overall treatment results [ 1 ]. Perioperative local antibiotic treatment has been widely clinically studied to date with generally promising results [ 2 – 5 ]. While most such studies have considered gentamicin [ 2 ] or vancomycin [ 3 , 4 ], it has been suggested that the administration of systemic rifampin improves the outcome in deep sternal wound infections caused by staphylococci following cardiac surgery [ 6 ] as well that of staphylococcal infections associated with stable orthopedic implants [ 7 ].…”

“…While most such studies have considered gentamicin [ 2 ] or vancomycin [ 3 , 4 ], it has been suggested that the administration of systemic rifampin improves the outcome in deep sternal wound infections caused by staphylococci following cardiac surgery [ 6 ] as well that of staphylococcal infections associated with stable orthopedic implants [ 7 ]. The local application of 250 mg of rifampin over the mesh during the inguinal hernia repair procedure has been reported to significantly reduce the occurrence of postoperative surgical site infection [ 5 ] without the need for systemic administration. Rifampin penetrates readily through the biofilm and is often recommended for the treatment of surgical site infections together with other antibiotics that act to prevent the rapid development of rifampin resistance [ 8 – 10 ].…”

Ventral Hernilerin Onarımında Polyester Film Kullanımının Erken ve İleri Dönem Sonuçlarının Değerlendirilmesi: Tavşan Modellerinde Deneysel Bir Çalışma

“…Regardless of the reason, operation is mandatory for the treatment of ventral hernias [18,20] . In cases where primary repair is inadequate, herniorrhaphy can be performed using various graft materials with organic or synthetic characteristics [12,17] .…”