Effect of Prophylactic Antibiotics in Preventing Wound Infection in Herinoplasty with Inguinal Mesh in Lichtenstein Method

Background and

Surgical site infections are infections of the tissues,organs,or spaces exposed by surgeons during performance of an invasive procedure,and the development of SSIs is related to the degree of microbial contamination of wound during surgery,duration of the procedure,and host factors.Inguinal hernioplasty is one of the most common surgical operations. The use of prophylactic antibiotic in Lichtenstein hernioplasty is controversial. Hence this study done to evaluate the prophylactic antibiotic effect in reducing the post operative wound infection in Lichtenstein hernioplasty.

This is an interventional double-blind randomized trial on 282 patients under going, Unilateral primary elective inguinal hernioplasty with Lichtenstein method. Using polypropylene mesh. They were randomized to receive 1gr/1v cephalotin (keflin) or equal volume of placebo 30min before incision. Patients were evaluated 1week, 2weeks and 12weeks after surgery by an independent surgeon or resident. Wound infection was defined according to the criteria of centers for Disease control and recorded. Results were assessed using chi-square and t-test as appropriate.

We included 282 patients in this study between March 2010 and october 2011. The total number of wound infection was 13 (4.7%), 4(2.8%) in antibiotic group and 9(6.4%) in placebo group (p= 0.29). There was 1 deep infection only in placebo group. Statistical analysis showed no significant difference in two groups.

The results show that, in Lichtenstein hernioplasty, routine use of prophylactic antibiotic is not indicated, as it does not significantly reduce the post operative surgical site infection rates.