Abstract

ROLE OF ANTIBIOTIC PROPHYLAXIS IN ELECTIVE MESH INGUINAL HERNIOPLASTY

Author(s): B. Santhi, Kenny Robert, Sudhagar Rengasamy

BACKGROUND Antibiotic prophylaxis use in mesh inguinal hernioplasty is controversial. A recent Cochrane review based on 17 randomised trials did not reach a conclusion on this important topic. Hence this study is designed to define the role of prophylactic antibiotics in mesh repair of inguinal hernia. MATERIALS AND METHODS We conducted a prospective, randomized control trial comparing wound infection rates in 60 patients (30 of them received intravenous Cefotaxime 1g stat and remaining 30 received a placebo) undergoing primary inguinal hernia repair electively using polypropylene mesh. All the 60 patients who completed a follow up period of one month were analysed. Age, co-morbidities, type of hernia, type of anaesthesia, pre and postoperative hospital stay and duration of surgery were recorded. CDC criteria was used to define wound infection. RESULTS Of the total 60 patients analysed, the overall infection rate was 1.7% (1 out of 60). Only one patient from control group developed a superficial SSI between 7th and 10th post-operative day (3.3%-1 out of 30). The incidence of wound infection in antibiotic group was none. CONCLUSION Antibiotic prophylaxis was associated with decrease in the incidence of SSI when compared to control group, but the difference was not statistically significant. Based on our study results we do not recommend the routine use of antibiotic prophylaxis in elective mesh repair of inguinal hernias.