scholarly journals Antibiotic Prophylaxis against Surgical Site Infection after Open Hernia Surgery: A Systematic Review and Meta-Analysis

2021 ◽  
pp. 1-13
Author(s):  
Lolwah Al Riyees ◽  
Wedad Al Madani ◽  
Nistren Firwana ◽  
Hanan H. Balkhy ◽  
Mazen Ferwana ◽  
...  
Keyword(s):  
Systematic Review ◽  
Hernia Repair ◽  
Surgical Site Infection ◽  
Antibiotic Prophylaxis ◽  
Meta Analysis ◽  
Prophylactic Antibiotics ◽  
Site Infection ◽  
Hernia Surgery ◽  
Significant Difference

<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.

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

2021 ◽  
Vol 108 (Supplement_7) ◽  
Author(s):  
Maitreyi Patel ◽  
Aleem O'Balogun ◽  
Naveed Kirmani
Keyword(s):  
Hernia Repair ◽  
Surgical Site Infection ◽  
Antibiotic Prophylaxis ◽  
Groin Hernia ◽  
Open Repair ◽  
Risk Category ◽  
Site Infection ◽  
Groin Hernia Repair ◽  
Hernia Surgery ◽  
International Guidelines

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.

scholarly journals P107 PREVENTION OF INCISIONAL HERNIA AFTER MIDLINE LAPAROTOMY WITH MODIFICATION OF CLOSURE TECHNIQUE: SYSTEMATIC REVIEW AND META ANALYSIS

2021 ◽  
Vol 108 (Supplement_8) ◽  
Author(s):  
Edgard Efren Lozada Hernandez ◽  
Juan Pablo Hernandez Bonilla ◽  
Enrique Obregon Moreno ◽  
Diego Hinojosa Ugarte ◽  
Aldo Jimenez Herevia ◽  
...  
Keyword(s):  
Systematic Review ◽  
Clinical Trials ◽  
Incisional Hernia ◽  
Surgical Site Infection ◽  
Meta Analysis ◽  
Wound Dehiscence ◽  
Site Infection ◽  
Closure Technique ◽  
Midline Laparotomy ◽  
Significant Difference

Abstract Aim “Incisional hernia is the main complication after laparotomy, the prevention of this is currently aimed at preoperative rehabilitation, modification of the closure technique and the use of prophylactic mesh. The objective of the study was to measure the effectiveness of the modification in the laparotomy closure technique to reduce the incidence of incisional hernia.” Material and Methods “A systematic review and meta-analysis were carried out following the PRISMA guidelines. The first objective was to determine the incidence of incisional hernia at one year of follow-up, comparing the modification in the closure technique with the usual closure. The secondary objective was to determine the difference in wound dehiscence and surgical site infection between these two groups. Only clinical trials were included, and the random effects method was used for their analysis. PROSPERO registration number: CRD42021231107” Results “Seven clinical trials were included, comparing 1612 patients, the incidence of incisional hernia was significantly lower in the surgical technique modification group OR 0.55 (95% CI 0.38-79). Efficacy to reduce the incidence of wound dehiscence was also analyzed without finding a difference between the two groups OR 0.58 (95% CI 0.27-1.21). There was no statistically significant difference between both groups when comparing seroma hematoma and surgical site infection.” Conclusions “The modification in the laparotomy closure technique reduces the incidence of incisional hernia. However, when analyzing globally, only the Small bites and Reinforced tension line techniques contributed to this result.”

scholarly journals Effect of postoperative continuation of antibiotic prophylaxis on the incidence of surgical site infection: a systematic review and meta-analysis

2020 ◽  
Vol 20 (10) ◽  
pp. 1182-1192 ◽  
Author(s):  
Stijn W de Jonge ◽  
Quirine J J Boldingh ◽  
Joseph S Solomkin ◽  
E Patchen Dellinger ◽  
Matthias Egger ◽  
...  
Keyword(s):  
Systematic Review ◽  
Surgical Site Infection ◽  
Antibiotic Prophylaxis ◽  
Meta Analysis ◽  
Site Infection

scholarly journals PREVENTION OF INCISIONAL HERNIA AFTER MIDLINE LAPAROTOMY WITH MODIFICATION OF CLOSURE TECHNIQUE: SYSTEMATIC REVIEW AND META ANALYSIS

2021 ◽  
Vol 108 (Supplement_3) ◽  
Author(s):  
E E Lozada Hernández ◽  
J P Hernández Bonilla ◽  
D Hinojosa Ugarte
Keyword(s):  
Systematic Review ◽  
Clinical Trials ◽  
Incisional Hernia ◽  
Surgical Site Infection ◽  
Meta Analysis ◽  
Wound Dehiscence ◽  
Site Infection ◽  
Closure Technique ◽  
Midline Laparotomy ◽  
Significant Difference

Abstract INTRODUCTION Incisional hernia is the main complication after laparotomy, the prevention of this is currently aimed at preoperative rehabilitation, modification of the closure technique and the use of prophylactic mesh. The objective of the study was to measure the effectiveness of the modification in the laparotomy closure technique to reduce the incidence of incisional hernia. MATERIAL AND METHODS. A systematic review and meta-analysis were carried out following the PRISMA guidelines. The first objective was to determine the incidence of incisional hernia at one year of follow-up, comparing the modification in the closure technique with the usual closure. The secondary objective was to determine the difference in wound dehiscence and surgical site infection between these two groups. Only clinical trials were included and the random effects method was used for their analysis. RESULTS Seven clinical trials were included, comparing 1612 patients, the incidence of incisional hernia was significantly lower in the surgical technique modification group OR 0.55 (95% CI 0.38-79). Efficacy to reduce the incidence of wound dehiscence was also analyzed without finding a difference between the two groups OR 0.58 (95% CI 0.27-1.21). There was no statistically significant difference between both groups when comparing seroma hematoma and surgical site infection. CONCLUSIONS The modification in the laparotomy closure technique reduces the incidence of incisional hernia. However, when analyzing globally, only the Small bites and Reinforced tension line techniques contributed to this result.

scholarly journals Network meta-analysis of antibiotic prophylaxis for prevention of surgical-site infection after groin hernia surgery

2017 ◽  
Vol 104 (2) ◽  
pp. e106-e117 ◽  
Author(s):  
T. Boonchan ◽  
C. Wilasrusmee ◽  
M. McEvoy ◽  
J. Attia ◽  
A. Thakkinstian
Keyword(s):  
Surgical Site Infection ◽  
Antibiotic Prophylaxis ◽  
Groin Hernia ◽  
Meta Analysis ◽  
Site Infection ◽  
Hernia Surgery ◽  
Groin Hernia Surgery

Antibiotic Prophylaxis in Patients Undergoing Open Mesh Repair of Inguinal Hernia: A Meta-Analysis

2012 ◽  
Vol 78 (3) ◽  
pp. 359-365 ◽  
Author(s):  
Yuan Yin ◽  
Turun Song ◽  
Banghua Liao ◽  
Qian Luo ◽  
Zongguang Zhou
Keyword(s):  
Inguinal Hernia ◽  
Hernia Repair ◽  
Surgical Site Infection ◽  
Antibiotic Prophylaxis ◽  
Mesh Repair ◽  
Meta Analysis ◽  
Controlled Trials ◽  
Site Infection ◽  
Open Mesh Repair ◽  
Open Mesh

The use of antibiotic prophylaxis in hernia repair is still under debate. The aim of this meta-analysis was to assess the effect of antibiotic prophylaxis in patients undergoing open mesh repair of inguinal hernia with respect to incidence of postoperative surgical site infection (SSI). A literature search was conducted in databases of MEDLINE, EMBASE, and Cochrane Central Register of Controlled Trials. Study selection, data extraction, quality assessment, and meta-analysis were conducted according to the recommendations by Cochrane collaboration. Nine randomized controlled trials were included. Incidence of surgical site infection was 39/1642 (2.38%) in the antibiotic group and 70/1676 (4.18%) in the control group. Antibiotics showed a protective effect in preventing SSI after mesh inguinal hernia repair (odds ratio: 0.61, 95% confidence interval: 0.40–0.92, I2: 0%). Antibiotic prophylaxis did reduce the incidence of SSI in hernia patients undergoing mesh hernioplasty. The cost effectiveness of antibiotic prophylaxis needs further evaluation.

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