scholarly journals Effect of single dose pre-operative antibiotic prophylaxis versus conventional antibiotic therapy in patients undergoing lichtenstein tension free mesh repair

2017 ◽  
Vol 4 (2) ◽  
pp. 738
Author(s):  
Madhu B. S. ◽  
Shashi Kumar H. B. ◽  
Naveen Kumar Reddy M. ◽  
Abilash V. Reddy ◽  
Sangeetha Kalabhairav
Keyword(s):  
Single Dose ◽  
Inguinal Hernia ◽  
Side Effects ◽  
Hernia Repair ◽  
Surgical Site Infection ◽  
Antibiotic Prophylaxis ◽  
Mesh Repair ◽  
Control Group ◽  
Site Infection ◽  
Tension Free

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.

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.

scholarly journals Surgical site infection following elective mesh repair of inguinal hernia: an analysis of risk factors

2020 ◽  
Author(s):  
Yeye Zhuo ◽  
Xinxin Li ◽  
Juntian Chen ◽  
Qian Zhang ◽  
De Cai
Keyword(s):  
Risk Factors ◽  
Inguinal Hernia ◽  
Surgical Site Infection ◽  
Antibiotic Prophylaxis ◽  
Mesh Repair ◽  
Multivariate Analyses ◽  
Current Smoker ◽  
Open Approach ◽  
Site Infection ◽  
Lymphocyte Ratio

Abstract Background: Surgical site infection (SSI) is a complication of mesh repair of inguinal hernia (IH) with an increase in length of stay and costs. We investigated both controllable and non-controllable risk factors for SSI following elective mesh repair of IH. Methods: A retrospective analysis was conducted of 1177 adult patients who underwent elective mesh repair of IH (not receiving antibiotic prophylaxis) from January 2010 to September 2019. Demographics, surgical variables and laboratory data were extracted from the electronic medical records. Receiver operating characteristic (ROC) analysis was performed to determine the optimal threshold of continuous variables. Independent risk factors for SSI were identified by univariate and multivariate analyses. Results: In total, 647 open and 530 laparoscopic IH repairs were included. The overall SSI rate within 30 days after surgery was 3.2% (39/1342 hernias) in the absence of antibiotic prophylaxis. Both the preoperative neutrophil‐lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR) were negatively correlated with the postoperative period of SSI (r = -0.368, P = 0.021; r = -0.334, P = 0.038, respectively). On multivariate analyses, body mass index (BMI) > 24.6 kg/m 2 (odds ratio [OR], 1.152; 95% confidence interval [CI], 1.041-1.275), current smoker (OR, 4.226; 95% CI, 1.222-14.611), preoperative NLR > 1.97 (OR, 3.670; 95% CI, 1.675-8.041), and open approach (OR, 4.866; 95% CI, 1.877-12.618) were significantly related to postoperative SSI. Conclusion: The controllable risk factors (elevated BMI, current smoker) found out here may help to identify patients at high-risk of SSI, allowing targeted preventive measures. Preoperative NLR > 1.97 is a previous unrecorded predictor for SSI following elective mesh repair of IH. Further study is needed to ascertain the magnitude of their effect.

Outcome of tension free open mesh repair of inguinal hernia

2020 ◽  
Vol 22 (1) ◽  
pp. 21-24
Author(s):  
Mohammad Masum ◽  
Md Aminul Islam ◽  
Masflque Ahmed Bhuiyan ◽  
Kazi Mazharul Lslam ◽  
Md Selim Morshed ◽  
...  
Keyword(s):  
Inguinal Hernia ◽  
Hernia Repair ◽  
Inguinal Hernia Repair ◽  
Mesh Repair ◽  
Groin Hernia ◽  
Synthetic Mesh ◽  
Indirect Inguinal Hernia ◽  
Prolene Mesh ◽  
Tension Free ◽  
Open Mesh Repair

Background: In the practice of General Surgery, hernia repair is the second most common procedure after appendectomy. Several methods have been developed over the years to try to improve hernia repair. Good result can be expected using Bassini's, McVay's, Shouldice's techniques provided the exact nature of hernia is recognized and the repair is done without tension using healthy tissue. The introduction of synthetic mesh started a new era in hernia surgery. The use of synthetic mesh repair of primary and recurrent hernias has gradually gained acceptance among surgeons. Objective: To find out the outcome and complications of open inguinal hernia repair with prolene mesh. Methods: This is a prospective cross sectional study conducted at Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, from December, 2011 to May, 2012. One hundred patients of inguinal hernia admitted in different surgical units of BSMMU, Dhaka for elective surgery were studied. We have given 1 gm ijv Cephradine per operatively and then 500 gm cephradine ijv 6 hourly for 24 hours followed by oral form of Cephradine for next 5 days. Polypropylene mesh of 11 cm x 7 cm size was used in all cases. All the operations were done by open tension free prolene mesh repair technique. Patients were followed for one year to see the outcome. Results: Out of 100 cases of inguinal hernia, 71 patients (71%) had indirect inguinal hernia and 29 cases (29%) had direct inguinal hernia; 90 cases (90%) were primary hernia and only 10 cases (10%) were recurrent hernia; 58 cases were right sided, 34 cases (34%) were left sided and 8 cases (8%) were bilateral. Complications of mesh repair of groin hernia in this study included wound infection (5%), scrotal oedema (2%), mesh infection (0%), scrotal hematoma (2%), echymoces of peri-incisional skin (5%), early wound and groin pain (7%), chronic inguinodynia (2%), hernia recurrence (1%). Conclusion: In the present study an attempt is made to evaluate the outcome of patients undergoing inguinal hernia repair by prolene mesh. The results confirm that Lichtenstein tension free mesh repair of inguinal hernia is safe and reliable for both primary and recurrent groin hernia, with less recurrence rate. Patient's compliance was good with minimum morbidity. Journal of Surgical Sciences (2018) Vol. 22 (1): 21-24

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 The A2B trial, antibiotic prophylaxis for excision-graft surgery in burn patients: a multicenter randomized double-blind study

Trials ◽  
2020 ◽  
Vol 21 (1) ◽  
Author(s):  
François Dépret ◽  
◽  
Boris Farny ◽  
Mathieu Jeanne ◽  
Kada Klouche ◽  
...  
Keyword(s):  
Surgical Site Infection ◽  
Antibiotic Prophylaxis ◽  
Controlled Study ◽  
Control Group ◽  
Placebo Control ◽  
Double Blind Study ◽  
Burn Patients ◽  
Site Infection ◽  
Postoperative Sepsis ◽  
Postoperative Infections

Abstract Background The indication for antibiotic prophylaxis in burn patients remains highly controversial, with no consensus having been reached. The objective of antibiotic prophylaxis is to reduce the risk of postoperative local and systemic infections. Burn surgery is associated with a high incidence of bacteremia, postoperative infections, and sepsis. However, antibiotic prophylaxis exposes patients to the risk of selecting drug-resistant pathogens as well as to the adverse effects of antibiotics (i.e., Clostridium difficile colitis). The lack of data precludes any strong international recommendations regarding perioperative prophylaxis using systemic antibiotics in this setting. The goal of this project is therefore to determine whether perioperative systemic antibiotic prophylaxis can reduce the incidence of postoperative infections in burn patients. Methods The A2B trial is a multicenter (10 centers), prospective, randomized, double-blinded, placebo-controlled study. The trial will involve the recruitment of 506 adult burn patients with a total body surface area (TBSA) burn of between 5 and 40% and requiring at least one excision-graft surgery for deep burn injury. Participants will be randomized to receive antibiotic prophylaxis (antibiotic prophylaxis group) or a placebo (control group) 30 min before the incision of the first two surgeries. The primary outcome will be the occurrence of postoperative infections defined as postoperative sepsis and/or surgical site infection and/or graft lysis requiring a new graft within 7 days after surgery. Secondary outcomes will include mortality at day 90 postrandomization, skin graft lysis requiring a new graft procedure, postoperative bacteremia (within 48 h of surgery), postoperative sepsis, postoperative surgical site infection, number of hospitalizations until complete healing (> 95% TBSA), number of hospitalization days living without antibiotic therapy at day 28 and day 90, and multiresistant bacterial colonization or infection at day 28 and day 90. Discussion The trial aims to provide evidence on the efficacy and safety of antibiotic prophylaxis for excision-graft surgery in burn patients. Trial registration ClinicalTrials.gov NCT04292054. Registered on 2 March 2020

scholarly journals Effect of Single-Dose Prophylactic Ampicillin and Sulbactam on Wound Infection After Tension-Free Inguinal Hernia Repair With Polypropylene Mesh

2001 ◽  
Vol 233 (1) ◽  
pp. 26-33 ◽  
Author(s):  
Mehmet A. Yerdel ◽  
Emin B. Akin ◽  
Sukru Dolalan ◽  
Ahmet G. Turkcapar ◽  
Mevlut Pehlivan ◽  
...  
Keyword(s):  
Single Dose ◽  
Inguinal Hernia ◽  
Hernia Repair ◽  
Wound Infection ◽  
Inguinal Hernia Repair ◽  
Polypropylene Mesh ◽  
Tension Free

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.

scholarly journals Analysis of Ultrasound-guided Ilioinguinal and Iliohypogastric Nerve Block in Tension-Free Inguinal Hernia Repair in Elderly Patients

2020 ◽  
Vol 4 (2) ◽  
Author(s):  
Qikai Liao ◽  
Dongmei Xie
Keyword(s):  
Inguinal Hernia ◽  
Elderly Patients ◽  
Hernia Repair ◽  
Inguinal Hernia Repair ◽  
Nerve Block ◽  
Control Group ◽  
Study Group ◽  
Ultrasound Guided ◽  
Hernia Sac ◽  
Tension Free

Objective: To explore the value of ultrasound-guided ilioinguinal and iliohypogastric nerve block (IINB) in tension-free inguinal hernia repair in elderly patients. Methods: A total of 70 elderly patients with tension-free inguinal hernia repair who treated in the hospital from April 2018 to November 2019 were selected and divided into two groups according to the random number table method, with 35 cases each. The control group underwent infiltration of local anesthesia(LA), and the study group added with IINB. The visual analogue scale (VAS) scores of the two groups of patients were compared. Results: The VAS score of the study group when pulling the hernia sac was lower than that of the control group, and the difference was statistically significant (P<0.05). Conclusion: IINB has good analgesic effect in tension-free inguinal hernia repair in elderly patients, and it is worth promoting.

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