THE ROLE OF SINGLE DOSE ANTIBIOTIC PROPHYLAXIS IN OPEN MESH REPAIR OF INGUINAL HERNIA: A PROSPECTIVE, DOUBLE BLIND RANDOMIZED TRIAL

NAME ADDRESS EMAIL ID OF THE CORRESPONDING AUTHOR:
Dr. Ketan K. Kapoor,
# 407, P. G. Men’s Hostel, BMCRI,
Bowring Hospital Road,
Shivaji Nagar,
Bangalore-560001.
E-mail: ketankap@hotmail.com

Abstract: OBJECTIVE: To assess the value of single-dose, intravenous, prophylactic antibiotic in the prevention of wound infections during tension free inguinal hernia mesh repair by a double-blind, prospective, randomized trial. BACKGROUND: Hernia repair is considered as one of the so-called 'clean' operations which may not require antibiotic coverage. Many surgeons, however, continue to give antibiotics empirically, as prophylaxis. This practice was more widely used after the establishment of the tension-free mesh repair technique as the method of choice for hernia repair, because of the fear of infection of the introduced foreign body. Several controlled randomised trials have been published on this topic, even before the introduction of the mesh repair techniques, however results are conflicting. METHODS AND MATERIALS: 200 patients were included in the study and the study population was randomized in two groups. The study group was administered parenteral cefazolin while the control group received placebo preoperatively. Follow up was done for 30 days post-surgery which included 180patients.The study was a double-blind randomized controlled trial, the results of which were analyzed statistically. RESULT: The overall infection rate was 8.3% (15 out of 180). The incidence of wound infection in antibiotic group was 7.4% and 9.3% in control group. There was no statistically significant difference in the infection rates between the two groups. CONCLUSION: Antibiotics showed a protective effect in preventing SSI after mesh inguinal hernia repair. However significant values cannot be obtained and cost effectiveness of antibiotic prophylaxis needs further evaluation. Therefore routine use is not recommended.

KEYWORDS: Inguinal hernia, prosthetic mesh, surgical site infection, antibiotic prophylaxis.