1- Assistant Professor, Department of surgery, Faculty of medicine, Kurdistan University of Medical Sciences, Sanandaj, Iran & Assistant Professor, Department of surgery, Faculty of medicine, Kurdistan University of Medical Sciences, Sanandaj, Iran 2- General surgeon, Department of surgery, Faculty of medicine, Kurdistan University of Medical Sciences, Sanandaj, Iran & General surgeon, Department of surgery, Faculty of medicine, Kurdistan University of Medical Sciences, Sanandaj, Iran , myfaridi69@gmail.com 3- Associate Professor, Department of Infectious Diseases, Faculty of medicine, Kurdistan University of Medical Sciences, Sanandaj, Iran & Associate Professor, Department of Infectious Diseases, Faculty of medicine, Kurdistan University of Medical Sciences, Sanandaj, Iran
Abstract: (773 Views)
Background and Aim: Inguinal hernia repair is performed in two ways, one without mesh and the other with mesh. Use of antibiotics is one of the major challenges in hernia mesh repair. The aim of this study was to investigate the effects of using and not using antibiotics on the infection of the site of operation. Materials and Methods: This prospective double-blind cohort study performed in Kosar Hospital in Sanandaj. Patients were placed in three groups and examined for postoperative infection at the surgical site. Group A received no antibiotics, group B received preoperative antibiotics and group C received postoperative antibiotics. Results: Among 186 patients, 56 were in group A, 62 in group B and 68 in group C. A total of 8 patients (4.3 percent) in 3 groups developed complications, which included erythema and discharge from the operation site. In group A, two patients and in group C, 6 patients developed surgical site infection, which showed no significant difference among the three groups (P = 0.317). There was no significant relationship between the incidence of the complications (R = 135, Adj.R2 = 0.007, P = 0.187) and age, residential place and site of operation. Conclusions: Based on the results of our study, antibiotics are not necessary in the patients undergoing inguinal hernia surgery with mesh. Therefore, routine antibiotic use should not be advocated. This viewpoint is very effective in reducing antibiotic resistance.
1. 1. Kulacoglu H. Current options in inguinal hernia repair in adult patients. Hippokratia. 2011;15(3):223.
2. Orelio CC, Hessen C, Sanchez-Manuel FJ, Aufenacker TJ, Scholten RJ. Antibiotic prophylaxis for prevention of postoperative wound infection in adults undergoing open elective inguinal or femoral hernia repair. Cochrane Database Syst Rev. 2020;4(4):CD003769. [DOI:10.1002/14651858.CD003769.pub5] [PMID] []
3. Subburathinam DA, Karthick MP, Princy J. Effectiveness of single over triple dose antibiotic prophylaxis in open inguinal hernioplasty. Int J Surg Open. 2021;5(1):297-300. [DOI:10.33545/surgery.2021.v5.i1e.628]
4. Yadav S, Kchhawa DS, Meena J. Effect of antibiotic prophylaxis in open inguinal hernioplasty (Lichtenstein hernia repair): a study in tertiary care center. Int J Surg. 2020;7(12):4034-8. [DOI:10.18203/2349-2902.isj20205353]
5. Fazal MI, Hassan M, Sandhu MF, Hamid A, Ali F, Hanif A, Batool T, Naseem M. Outcome Difference of Inguinal Mesh Hernioplasty using Postoperative Antibiotics Versus no use of Antibiotics, P J M H S. 2021:15( 1):167-169.
6. Shankar VG, Srinivasan K, Sistla SC, Jagdish S. Prophylactic antibiotics in open mesh repair of inguinal hernia-a randomized controlled trial. Int J Surg. 2010;8(6):444-7. [DOI:10.1016/j.ijsu.2010.05.011] [PMID]
7. Aktuğ CA, Göktaş S, Gezginci E. When Should Antibiotic Prophylaxis Be Performed to Prevent Surgical Field Infections? A Systematic Review. Gümüşhane Univ J Health Sci. 2020;9(4):402-6. [DOI:10.37989/gumussagbil.847328]
8. Sereysky J, Parsikia A, Stone ME, Castaldi M, McNelis J. Predictive factors for the development of surgical site infection in adults undergoing initial open inguinal hernia repair.Hernia.2020;24(1):173-8 [DOI:10.1007/s10029-019-02050-3] [PMID]
9. Russell D, Cole W, Yheulon C, Wren S, Kellicut D, Lim R. USA Department of Defense audit of surgical antibiotic prophylaxis prescribing patterns in inguinal hernia repair. Hernia. 2021;25(1):159-64. 10. Jain SK, Hameed T, Jain D, Singh M, Nizam A. The role of antibiotic prophylaxis in lichtenstein repair of primary inguinal hernia: A prospective double-blind randomized placebo-controlled trial. Niger J Surg. 2021;27(1):5. [DOI:10.4103/njs.NJS_52_19] [PMID] []
10. Li JF, Lai DD, Zhang XD, Zhang AM, Sun KX, Luo HG, Yu Z. Meta-analysis of the effectiveness of prophylactic antibiotics in the prevention of postoperative complications after tension-free hernioplasty. Can J Surg. 2012;55(1):27. [DOI:10.1503/cjs.018310] [PMID] []
11. Razafinimanana M, Aoun O, Durond S, Pasquier P, Kassi F, Malgras B. Relevance of Antibiotic Prophylaxis in Non-Mesh Inguinal Hernia Repair in Remote and Poor Medical Settings in Sub-Saharan Africa. Surg Infect (Larchmt). 2021. doi: 10.1089/sur.2020.387. [DOI:10.1089/sur.2020.387] [PMID]
12. Zhuo Y, Li X, Chen J, Zhang Q, Cai D. Surgical site infection following elective mesh repair of inguinal hernia: an analysis of risk factors. Res Sq. 2020. doi: 10.21203/rs.2.20847/v1. [DOI:10.21203/rs.2.20847/v1]
13. MacCormick AP, Akoh JA. Survey of surgeons regarding prophylactic antibiotic use in inguinal hernia repair. Scand J Surg. 2018;107(3):208-11. [DOI:10.1177/1457496917748229] [PMID]
14. Maheshwari MK, Singh R, Gupta S. Evaluation of administration of prophylactic antibiotics in mesh repair of inguinal hernia. Internat Surg J. 2019;6(5):1487-94. [DOI:10.18203/2349-2902.isj20191550]
15. Yin Y, Song T, Liao B, Luo Q, Zhou Z. Antibiotic prophylaxis in patients undergoing open mesh repair of inguinal hernia: a meta-analysis. Am Surg. 2012;78(3):359-65. [DOI:10.1177/000313481207800348] [PMID]
16. Rajapaksha K, Herath A, Silva LJ, Anandappa MD, Bandara TM. Prophylactic antibiotic for open mesh repair of inguinal hernia; from principe to nécessité. Int J Abdom Wall Hernia Surg. 2019;2(2):50. [DOI:10.4103/ijawhs.ijawhs_2_19]
17. Yang H, Xiong Y, Chen J, Shen Y. Study of mesh infection management following inguinal hernioplasty with an analysis of risk factors: a 10-year experience. Hernia. 2019;2019:1-5. [DOI:10.1007/s10029-019-01986-w] [PMID]
18. Siddiqui MA, Aleem MA, Rahman MS, Zafreen F. Role of Prophylactic Antibiotics in Open Mesh Inguinal Hernia Repair. Armed Forces Med Coll. 2017;13(2):18-21. [DOI:10.3329/jafmc.v13i2.41367]
19. Kahla SM, Gaber A, Al-Rahawy MM. The role of antibiotic prophylaxis in the prevention of surgical-site infection after hernioplasty in Menoufia University Hospital. Menoufia Med J. 2019;32(3):1137. [DOI:10.4103/mmj.mmj_10_16]
20. Sethi D, Griwan MS. The role of antibiotic prophylaxis in prevention of wound infection after lichtenstein open mesh repair of primary inguinal hernia. Int J Healthcare Biomed Res. 2017;5(03):24-35.
21. Koopman E, Nix DE, Erstad BL, Demeure MJ, Hayes MM, Ruth JT, Matthias KR. End-of-procedure cefazolin concentrations after administration for prevention of surgical-site infection. Am J Health Syst Pharm. 2007;64(18):1927-34. [DOI:10.2146/ajhp070047] [PMID]
22. Francetić I, Sardelić S, Bukovski-Simonoski S, Santini M, Betica-Radić L, Belina D, et al. ISKRA guidelines for antimicrobial prophylaxis in surgery-Croatian national guidelines. Liječnički vjesnik. 2010;132(7-8):203-17.
23. Woods RK, Dellinger EP. Current guidelines for antibiotic prophylaxis of surgical wounds. Am Fam Physician. 1998;57(11):2731.
24. Surahio AR, Khan AA, Farooq MU, Fatima I. Single versus 3-dose antibiotic prophylaxis in clean and clean contaminated operations. J Ayub Med Coll Abbottabad. 2010;22(4):91-4.
25. Ismaila BO, Alayande BT, Ojo EO, Sule AZ. Inguinal hernia repair in Nigeria: a survey of surgical trainees. Hernia. 2019;23(3):625-9. [DOI:10.1007/s10029-019-01885-0] [PMID]
26. Alagarsamy GS, Ramasamy R. The efficacy of antibiotic prophylaxis in preventing SSI (surgical site infection) in patients undergoing Lichenstein's hernioplasty at our tertiary care centre. Int Surg J. 2017;4(6):1922-5. [DOI:10.18203/2349-2902.isj20172054]
27. Ding Y, Hu Y, Fan J, Tao Q. Experience of Diagnosis and Treatment in Mesh-Related Infection After Inguinal Hernia Repair. Ann Gastroenterol Dig Syst. 2021;4(1):1032.
28. Bhanbhro RJ, Almani KA, Kazi S. Antibiotic Prophylaxis In Preventing Surgical Site Infection In Patients Undergoing Lichtenstein's Hernioplasty. J Bahria Univ Med Dent College. 2018;2018:147. [DOI:10.51985/JBUMDC2018025]
29. Jain SK, Jayant M, Norbu C. The role of antibiotic prophylaxis in mesh repair of primary inguinal hernias using prolene hernia system: a randomized prospective double-blind control trial. Trop Doct. 2008;38(2):80-2. [DOI:10.1258/td.2007.060031] [PMID]
30. Terzi C. Antimicrobial prophylaxis in clean surgery with special focus on inguinal hernia repair with mesh. J Hosp Infect. 2006;62(4):427-36. [DOI:10.1016/j.jhin.2005.09.017] [PMID]
31. White A, Schneider T. Improving compliance with prophylactic antibiotic administration guidelines. AORN J. 2007;85(1):173-80. [DOI:10.1016/S0001-2092(07)60023-4] [PMID]
Eliasi A, Faridi M Y, Rahmanpanah N, Mohsenpour B, Safarnejad F. Evaluation of Antibiotic Efficacy Before and After Surgery for Inguinal Hernia Repair With Mesh in the Prevention of Surgical Site Infection. SJKU 2025; 29 (6) :45-52 URL: http://sjku.muk.ac.ir/article-1-7873-en.html