Effectiveness of Prophylaxis Antibiotic Used for Tension-free Hernioplasty: A Randomized Double-blinded Placebo-controlled Trial

Authors

  • Wibun Phanthabordeekorn Department of Surgery, Paholpolpayuhasaena General Hospital, Kanchanaburi, Thailand

Keywords:

inguinal hernioplasty, mesh graft, prophylactic antibiotic, surgical wound infection

Abstract

Objective: To evaluate the effectiveness of prophylaxis antibiotic used for tension-free hernioplasty on
prevention of surgical wound infection.
Materials and Methods: After having permission from the Ethical Review Board of the hospital, this
randomized double-blinded placebo-controlled trial was performed from September 2010 to June 2011. One
hundred and six patients with inguinal hernias, American Society of Anesthesiologists (ASA) Class 1-2, who
never had allergy to cephalosporin and aged over 18 years-old were included. Fifty and 56 patients were
allocated to the intervention and control groups, respectively.
Results: At one-week follow-up, there was no difference of infection rate among the control and
intervention groups. In other words, there was no sign of wound infection found in all of 106 patients. All
patients did well without sign of wound infection at one-month follow-up.
Conclusion: There is no clear benefit of preoperative prophylactic antibiotic for prevention of post
inguinal hernioplasty wound infection. For deep surgical site infection, a longer follow-up at one year is needed
for completion of CDC criteria.

References

1. Falagas ME, Kasiakou SK. Mesh- related infection after
hernia repair surgery. Clin Microbiol Infect 2005;11:3-8.

2. Delikoukos S, Tzovaras G, Liakou P, Mantzos F, Hatzitheofilou
C. Late-onset deep mesh infection after inguinal hernia
repair. Hernia 2007;11:15-7.

3. Bueno Lledó J, Sosa Quesada Y, Gomez I Gavara I, Vaqué
Urbaneja J. Prosthetic infection after hernioplasty: Five
years experience. Cir Esp 2009;85:158-64.

4. Perez AR, Roxas MF, Hilvano SS. A randomized, doubleblind,
placebo-controlled trial to determine effectiveness
of antibiotic prophylaxis for tension-free mesh herniorrhaphy.
J Am Coll Surg 2004;200:393-7.

5. 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;38:80-2.

6. Terzi C. Antimicrobial prophylaxis in clean surgery with
special focus on inguinal hernia repair with mesh. J Hosp
Infect 2006;62:427-36.

7. Aufenacker TJ, van Geldere D, van Mesdag T, et al. The role
of antibiotic prophylaxis in prevention of wound infection
after Lichtenstein open mesh repair of primary inguinal
hernia: a multicenter double-blind randomized controlled
trial. Ann Surg 2004;240:955-61.

8. Simons MP, Aufenacker T, Bay-Nielsen M, et al. European
Hernia Society guidelines on the treatment of inguinal hernia
in adult patients. Hernia 2009;13:343-403.

9. Sanabria A, Domingues LC, Valdivieso E. Prophylactic antibiotics
for mesh inguinal hernioplasty: a meta-analysis. Ann
Surg 2007;245:392-6.

10. Celdrán A, Granizo JJ. Antibiotic prophylaxis for hernia
repair. J Am Coll Surg 2006;203:138-9.

11. Sanchez-Manuel FJ, Lozano-García J, Seco-Gil JL. Antibiotic
prophylaxis for hernia repair. Cochrane Database Syst Rev
2007;3:CD003769.

12. Othman I. Prospective randomized evaluation of
prophylactic antibiotic usage in patients undergoing tension
free inguinal hernioplasty. Hernia 2011;15:309-13.

13. Shankar VG, Srinivasan K, Sistla SC, Jagdis S. Prophylactic
antibiotics in open mesh repair of inguinal hernia - a
randomized controlled trial. Int J Sur 2010;8:444-7.

Downloads

Published

2011-12-30

How to Cite

1.
Phanthabordeekorn W. Effectiveness of Prophylaxis Antibiotic Used for Tension-free Hernioplasty: A Randomized Double-blinded Placebo-controlled Trial. Thai J Surg [Internet]. 2011 Dec. 30 [cited 2024 Apr. 25];32(4). Available from: https://he02.tci-thaijo.org/index.php/ThaiJSurg/article/view/227311

Issue

Section

Original Articles