Prospective randomized evaluation of prophylactic antibiotic usage in patients undergoing tension free inguinal hernioplasty.
OBJECTIVE
Assessment of the usefulness of antibiotic prophylaxis in inguinal hernioplasty.


METHODS
This prospective randomized double blind study was conducted on 98 patients. Group A (50 patients) received a single dose of intravenous amoxicillin and clavulanic acid, and Group P (48 patients) received an equal volume of normal saline placebo by intravenous bolus 30 min before the induction of anesthesia. Hernioplasty was performed with polypropylene mesh. Skin was closed using skin staples that were removed after complete wound healing. The surgical site infection was diagnosed according to APIC, CDC criteria ( http://www.apic.org ).


RESULTS
The mean operative time was 38.8  ± 10.8 min in group A versus 40.9 ± 11.1 min in group P (P  = 0.34). The mean hospitalization time was 1.3 ± 0.463 days in group A versus 1.25 ± 0.438 days in group P (P = 0.58). Four patients (2%) in group A and 6 patients (2.88%) in group P had wound infections (P = 0.47). Group A had 3 superficial infections and 1 deep infection while group P had 5 superficial infections and 1 deep infection. Antibiotic treatment of the wound infection was successful in all patients. Wound culture showed Staphylococcus aureus infection in 1 patient each group, Streptococcus pyogenes in 1 group A patient and Pseudomonas aeruginosa in 1 group P patient. Cultures in other patients in both groups were reported to be sterile.


CONCLUSIONS
Prophylactic antibiotic usage in patients undergoing tension free inguinal hernioplasty did not show any statistically significant beneficial effects in reduction of surgical site infection.
Department of General Surgery, Tanta University, Tanta, Egypt. ibrahimothman000@yahoo.com
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Othman
D000328:Adult; D000368:Aged; D019980:Amoxicillin-Potassium Clavulanate Combination / Q000627:therapeutic use*; D019072:Antibiotic Prophylaxis; D004311:Double-Blind Method; D005260:Female; D006552:Hernia, Inguinal / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D011552:Pseudomonas Infections / Q000453:epidemiology / Q000517:prevention & control; D013203:Staphylococcal Infections / Q000453:epidemiology / Q000517:prevention & control; D013290:Streptococcal Infections / Q000453:epidemiology / Q000517:prevention & control; D013526:Surgical Mesh; D013530:Surgical Wound Infection / Q000453:epidemiology / Q000517:prevention & control*; D055815:Young Adult
D019980:Amoxicillin-Potassium Clavulanate Combination
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