Prophylactic antibiotic use in elective inguinal hernioplasty in a trauma center

Ergül, Zafer; Akıncı, Melih; Ugurlu, Celil; Kulaçoğlu, Hakan; Yılmaz, Kerim Bora

doi:10.1007/s10029-011-0881-2

Cited by 27 publications

(33 citation statements)

References 32 publications

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“…They concluded that antibiotic prophylaxis has no benefit in the incidence of SSI in elective repair of inguinal hernias with mesh. 18 Similar results were documented by Jain et al, 19 Tzovaras et al, 20 and Aufenacker et al, 21 which did not support the use of prophylactic antibiotics in low-risk patients with inguinal mesh hernioplasty.…”

Section: Discussionsupporting

confidence: 86%

The role of prophylactic cefazolin in the prevention of infection after various types of abdominal wall hernia repair with mesh

Bahar

Nooghabi

et al. 2015

Asian Journal of Surgery

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Section: Discussionsupporting

confidence: 86%

The role of prophylactic cefazolin in the prevention of infection after various types of abdominal wall hernia repair with mesh

Bahar

Nooghabi

et al. 2015

Asian Journal of Surgery

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“…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]. Drawing from such conflicting evidence, there is understandable inconsistency between clinical guidelines: in England and Wales, the National Institute of Clinical Excellence (NICE) recommend the use of antibiotic prophylaxis in clean surgery with implanted material [9] but guidelines issued by the Scottish Intercollegiate Guideline Network (SIGN) state that antibiotic prophylaxis is not needed in inguinal hernia repair with or without implanted mesh [10].…”

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

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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.

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“…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. The National Institute of Clinical Excellence (NICE) recommend the use of antibiotic prophylaxis in clean surgery with implanted material.…”

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

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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.

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Prophylactic antibiotic use in elective inguinal hernioplasty in a trauma center

Abstract: In our settings antibiotic prophylaxis has no significant effect on the incidence of SSI in elective repair of inguinal hernias with mesh. The most effective way to reduce the incidence of infection in prosthetic repair may be a specific center for treatment of abdominal wall hernias.

Cited by 27 publications

References 32 publications

The role of prophylactic cefazolin in the prevention of infection after various types of abdominal wall hernia repair with mesh

The role of prophylactic cefazolin in the prevention of infection after various types of abdominal wall hernia repair with mesh

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

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

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