Meta-analysis of the effectiveness of prophylactic antibiotics in the prevention of postoperative complications after tension-free hernioplasty

Li, Jianfang; Lai, Dandan; Zhang, Xiaodong; Zhang, Aimin; Sun, Kuan-Xue; Luo, Heng-Gui; Yu, Zhen

doi:10.1503/cjs.018310

Cited by 32 publications

(14 citation statements)

References 26 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…A separate meta-analysis, also published in 2012, focussed purely on inguinal hernia repair with mesh and included six of the 11 RCTs identified by the Cochrane review. This analysis concluded that there was a significant benefit associated with prophylaxis [7]. One further RCT has recently been reported: this small study found no significant difference in risk of infection between use of prophylaxis and placebo [8].…”

Section: Introductionmentioning

confidence: 99%

Use of antibiotic prophylaxis in elective inguinal hernia repair in adults in London and south-east England: a cross-sectional survey

Aiken¹,

Haddow²,

Symons³

et al. 2013

Hernia

View full text Add to dashboard Cite

PurposeEvidence regarding whether or not antibiotic prophylaxis is beneficial in preventing post-operative surgical site infection in adult inguinal hernia repair is conflicting. A recent Cochrane review based on 17 randomised trials did not reach a conclusion on this subject. This study aimed to describe the current practice and determine whether clinical equipoise is prevalent.MethodsSurgeons in training were recruited to administer the Survey of Hernia Antibiotic Prophylaxis usE survey to consultant-level general surgeons in London and the south-east of England on their practices and beliefs regarding antibiotic prophylaxis in adult elective inguinal hernia repair. Local prophylaxis guidelines for the participating hospital sites were also determined.ResultsThe study was conducted at 34 different sites and received completed surveys from 229 out of a possible 245 surgeons, a 93 % response rate. Overall, a large majority of hospital guidelines (22/28) and surgeons’ personal beliefs (192/229, 84 %) supported the use of single-dose pre-operative intravenous antibiotic prophylaxis in inguinal hernia repair, although there was considerable variation in the regimens in use. The most widely used regimen was intravenous co-amoxiclav (1.2 g). Less than half of surgeons were adherent to their own hospital antibiotic guidelines for this procedure, although many incorrectly believed that they were following these.ConclusionIn the south-east of England, there is a strong majority of surgical opinion in favour of the use of antibiotic prophylaxis in this procedure. It is therefore likely to be extremely difficult to conduct further randomised studies in the UK to support or refute the effectiveness of prophylaxis in this commonly performed procedure.

show abstract

Section: Introductionmentioning

confidence: 99%

Use of antibiotic prophylaxis in elective inguinal hernia repair in adults in London and south-east England: a cross-sectional survey

Aiken¹,

Haddow²,

Symons³

et al. 2013

Hernia

View full text Add to dashboard Cite

show abstract

“…The Lichtenstein tension-free hernia repair gained broad acceptance especially in the last decade due to its being an easily applied technique with low recurrence rates (1). However the polypropylene mesh used in this technique has given rise to complications like foreign body reaction, "Surgical Site Infection (SSI)", seroma, adhesion, graft migration, graft rejection and chronic pain (2)(3)(4). All these probable complications result in an increase in morbidity, length of hospital stay and cost.…”

Section: Introductionmentioning

confidence: 99%

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

Kahramanca

Kaya

Azılı

et al. 2013

UCD

View full text Add to dashboard Cite

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.

show abstract

“…This analysis concluded that there was a significant benefit associated with prophylaxis. 10 Another RCT has found no significant difference in risk of infection between use of prophylaxis and placebo. 11 Because of the differing conclusions from various studies, the clinical guidelines vary.…”

Section: Discussionmentioning

confidence: 99%

Comparative study of use of prophylactic antibiotic for elective hernia repair with use of prosthetic material: observational study in a tertiary care institute

et al. 2017

View full text Add to dashboard Cite

Background: There is widespread misuse of antibiotics leading to increasing reports of drug resistance. This has been highlighted by the World Health Organization (WHO). Wrong antibiotics are chosen, used when not indicated and used in dosages or patterns that are not recommended. We tried to analyse the pattern of antibiotic use for elective hernia repair using polypropylene mesh among the surgical units in our hospital for elective clean cases. The antibiotic use pattern and the incidence of surgical site infections were to be analysed to create uniform policies for antibiotic use across the institution.Methods: We looked at the case records of patients undergoing elective hernia repair in one month in our institution under different surgeons. Inguinal, umbilical and simple incisional hernias were taken into study. Both open and laparoscopic hernia repairs were included in the study. Emergency hernia repairs were excluded. We looked at the type of prophylactic antibiotic given, the dose and approximate time difference between injection and incision time, whether patient received further doses of intravenous or oral antibiotic. If further doses were given, we also looked for reasons if documented. These cases were followed for one month to see if there was any difference in the incidence of surgical site infections.Results: There were thirty-one cases, of which 16 received only a single dose of prophylactic antibiotic while 15 received more than one dose of antibiotic. Only one patient in the prophylactic antibiotic only group developed a culture positive wound infection. There was seroma formation in two patients.Conclusions: There was no evidence of higher incidence of wound infection in patients receiving only prophylactic antibiotic. There is a need for developing institution specific policies on antibiotic use. This will reduce the treatment costs and also avoid the development of antibiotic resistance in the society.

show abstract

Meta-analysis of the effectiveness of prophylactic antibiotics in the prevention of postoperative complications after tension-free hernioplasty

Cited by 32 publications

References 26 publications

Use of antibiotic prophylaxis in elective inguinal hernia repair in adults in London and south-east England: a cross-sectional survey

Use of antibiotic prophylaxis in elective inguinal hernia repair in adults in London and south-east England: a cross-sectional survey

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

Comparative study of use of prophylactic antibiotic for elective hernia repair with use of prosthetic material: observational study in a tertiary care institute

Contact Info

Product

Resources

About