EP.TH.747Audit of antibiotic prophylaxis in groin hernia repair

2021 ◽  
Vol 108 (Supplement_7) ◽  
Author(s):  
Maitreyi Patel ◽  
Aleem O'Balogun ◽  
Naveed Kirmani

Abstract Aims To review practice of antibiotic prophylaxis in patients undergoing groin hernia repair against the International guidelines for groin hernia management 2018, in order to improve compliance with International Guidelines. We also assessed the risk category of patients. Methods Retrospective data of all patients undergoing groin hernia repair from November 2019 to March 2020 was collected using hospital software. Data collected included patient demographics, details of hernia repair including; primary/recurrent hernia, emergency/elective, laparoscopic/open repair and use of mesh. The details of antibiotic prophylaxis were recorded. Descriptive statistics was used. Data was analyzed using Microsoft Excel. Results 67 patients were included, of which 38(57%) were high risk. 62 (92.5%) primary repairs were done, of which 48(72%) were open. 62(92.5%) were operated electively. 46(69%) patients underwent open repair with mesh, 6(9%) had open repair without mesh, while 15(22%) had laparoscopic repair with mesh. A total of 45 (67%) patient received antibiotic prophylaxis. Adherence to International guidelines for groin hernia in open hernia surgery was 82.67%, while that for laparoscopic surgery was 60%. Overall adherence to the Guidelines was 56.67%. Conclusions The audit reflects the need for improved understanding and adherence to the International Guidelines. Data collection of surgical site infection can help inform and influence practice to minimize the risk for surgical site infection and assist in better communication with patients regarding risk. Risk assessment for surgical site infection of patients prior to procedure helps to identify those with indication of antibiotic prophylaxis.

2021 ◽  
pp. 1-13
Author(s):  
Lolwah Al Riyees ◽  
Wedad Al Madani ◽  
Nistren Firwana ◽  
Hanan H. Balkhy ◽  
Mazen Ferwana ◽  
...  

<b><i>Objective:</i></b> The role of antibiotic prophylaxis (AP) in the prevention of surgical site infection (SSI) after hernia repair is debated. We conducted this systematic review and meta-analysis to assess the evidence on the value of prophylactic antibiotics in reducing the risks of SSI after open hernia surgery. <b><i>Methods:</i></b> We ran an online and manual search to identify relevant randomized controlled trials that compared prophylactic antibiotics to nonantibiotic controls in patients undergoing open surgical hernia repair. Data on SSI risk were extracted and pooled as risk ratios (RRs) with 95% confidence intervals (95% CIs), using RevMan software. We further used the Cochrane risk of bias tool and GRADE assessment to evaluate the quality of generated evidence. <b><i>Results:</i></b> Twenty-nine studies (<i>N</i> = 8,616 patients) were included in the current analysis. Antibiotic prophylaxis reduced the risk of SSI in open hernia repair patients (RR = 0.65, 95% CI = 0.53, 0.79). Subgroup analysis showed a significant benefit for antibiotics in mesh repair patients (RR = 0.60, 95% CI = 0.48, 0.76) yet no significant difference in SSI risk after herniorrhaphy (RR = 0.86, 95% CI = 0.54, 1.36). In addition, AP was associated with a significant reduction in superficial SSI risk (RR = 0.56, 95% CI = 0.43, 0.72) but not deep SSI (RR = 0.70, 95% CI = 0.30, 1.62). Further analysis showed a significant reduction in SSI risk with amoxicillin/clavulanic acid and cefazolin but not with cefuroxime. <b><i>Conclusion:</i></b> The present meta-analysis suggests that AP is beneficial prior to open mesh hernia repair. However, the quality of evidence was low, and further well-designed trials are needed.


2004 ◽  
Vol 91 (1) ◽  
pp. 105-111 ◽  
Author(s):  
E. W. Taylor ◽  
K. Duffy ◽  
K. Lee ◽  
R. Hill ◽  
A. Noone ◽  
...  

2004 ◽  
Vol 91 (4) ◽  
pp. 509-509
Author(s):  
A. Gaunt ◽  
E. S. McKain ◽  
A. Feroz ◽  
B. M. Stephenson

2004 ◽  
Vol 91 (5) ◽  
pp. 647-647 ◽  
Author(s):  
S. Kumar ◽  
P. Foo Wong ◽  
A. Melling ◽  
D.J. Leaper

2017 ◽  
Vol 104 (2) ◽  
pp. e106-e117 ◽  
Author(s):  
T. Boonchan ◽  
C. Wilasrusmee ◽  
M. McEvoy ◽  
J. Attia ◽  
A. Thakkinstian

1997 ◽  
Vol 21 (8) ◽  
pp. 811-815 ◽  
Author(s):  
Eric W. Taylor ◽  
Derek J. Byrne ◽  
David J. Leaper ◽  
Stephan J. Karran ◽  
M. Kennedy Browne ◽  
...  

2014 ◽  
Vol 207 (4) ◽  
pp. 476-484 ◽  
Author(s):  
Takero Mazaki ◽  
Kazunari Mado ◽  
Hideki Masuda ◽  
Motomi Shiono ◽  
Noahiro Tochikura ◽  
...  

2017 ◽  
Vol 4 (2) ◽  
pp. 738
Author(s):  
Madhu B. S. ◽  
Shashi Kumar H. B. ◽  
Naveen Kumar Reddy M. ◽  
Abilash V. Reddy ◽  
Sangeetha Kalabhairav

Background: Rational use of antibiotic is important as injudicious use can adversely affect the patient, cause emergence of antibiotic resistance and increase the cost of health care. The efficacy of antibiotic prophylaxis in preventing surgical site infection in patients undergoing Lichtenstein tension free inguinal hernia repair still remains controversial.Methods: A randomized controlled trial was conducted in patients undergoing lichtenstein tension free inguinal hernia repair between January 2015 to June 2016, and the results were compared with the control group in whom, conventional antibiotics were given for 7 days . All patients in study group undergoing surgery were given 400 mg parenteral ciprofloxacin 30 min prior to surgery. In the control group, the patients were given 2 days parenteral ciprofloxacin 400 mg twice a day and the next 5 days the same antibiotics were given in oral route, after surgery. Total 100 patients were randomized to 50 each group. The outcome in terms of duration of surgery, surgical site infection, cost and antibiotic side effects were then compared.Results: The duration of the hospital stay, cost and side effects are significantly higher in the control group patients. Antibiotic side effects (P < 0.05) were high for control group. The infection rate was same in both the groups. There was no significant difference in terms of infection rate among two groups.Conclusions: This study concludes that prophylactic single-dose antibiotic is effective in preventing surgical site infection and is cost-effective in patients undergoing lichtenstein tension free mesh repair.


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