The Role of Antibiotic Prophylaxis in Elective Tension Free Mesh Inguinal Hernioplasty

Abstract

Objective:To determine whether the use of prophylactic antibiotics is effective in the prevention of postoperative wound infection after open tension free repair of inguinal hernia.Methods: 150 Patients with a primary inguinal hernia repair were randomized in two groups .One group given a preoperative single dose of 1.5 g intravenous cephalosporin and the other group was given a placebo. Patients with recurrent hernias, immunosuppressive diseases, or allergies for the given antibiotic were excluded. Infection,seroma ,wound dehiscence etc was defined and their incidence noted. Follow up of the patients were done at I week,2 week and than 1 month.Results: Groups were well matched for all preoperative variables studied, including comorbid conditions. Superficial surgical site infection developed in 2 patients (1.7%) from the antibiotic group and 3 (3.3%) from the placebo group (p = 0.50). One from each group developed deep surgical site infection. Both patients were readmitted and underwent repeated debridement, which eventually resulted in graft loss.Conclusion: A low percentage of wound infection after primary open mesh inguinal hernia repair was found, and there was no significant difference between the antibiotic prophylaxis or placebo group. The results show that in primary hernia repair, antibiotic prophylaxis is not indicated in low-risk patients.