Role of Intravenous Cefuroxime Antibiotic Prophylaxis in the Prevention of Surgical Site Infection in Open Mesh Inguinal Hernia Repair
DOI:
https://doi.org/10.51253/pafmj.v73i6.11424Keywords:
Mesh inguinal hernia repair, Pre-operative cefuroxime administration, Surgical (SSI), Wound Infection (WI)Abstract
Objective: To compare pre-operative intravenous Cefuroxime prophylaxis to no prophylaxis regarding the development of
surgical site infection in inguinal hernia mesh repair.
Study Design: Quasi-experimental study.
Place and Duration of Study: Department of Surgery, Combined Military Hospital, Bahawalnager Pakistan, from Nov 2015
to Nov 2017.
Methodology: A total of 230 patients were included (115 patients in each group). Group-A patients were subjected to preoperative administration of 1.5 gm intravenous Cefuroxime 1 hour before surgery, while Group B patients were subjected to
no antibiotic prophylaxis following mesh repair. Development of post-operative surgical site infection (SSI) was checked till
the 30th post-operative day (POD).
Results: Post-operative surgical site infection was comparatively less in Group-A (3.4%) as compared to Group-B (10.4%),
which was statistically significant (p-value0.038).
Conclusion: Pre-operative intravenous Cefuroxime prophylaxis significantly reduces post-operative SSI following mesh
inguinal hernia repair.
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Heal CF, Banks JL, Lepper PD, Kontopantelis E, van Driel ML.Topical antibiotics for preventing surgical site infection inwounds healing by primary intention. Cochrane Database SystRev 2016; 11(11): CD011426.https://doi.org/10.1002/14651858.CD011426.pub2.
Baracs J, Huszár O, Sajjadi SG, Horváth OP. Surgical siteinfections after abdominal closure in colorectal surgery usingtriclosan-coated absorbable suture (PDS Plus) vs. uncoatedsutures (PDS II): a randomized multicenter study. Surg Infect2011; 12(6): 483-489. https://doi.org/10.1089/sur.2011.001.
Barbadoro P, Marmorale C, Recanatini C, Mazzarini G.Drainages Collaborative Working Group. May the drain be a
way in for microbes in surgical infections? Am J Infect Control2016; 44(3): 283-288. https://doi.org/10.1016/j.ajic.2015.10.012.
Walming S, Angenete E, Block M, Bock D, Gessler B, Haglind E,et al. Retrospective review of risk factors for surgical wound
dehiscence and incisional hernia. BMC Surg 2017; 17(1): 19.https://doi.org/10.1186/s12893-017-0207-0.
Edmiston CE Jr, Leaper DJ. Intra-Operative Surgical Irrigation ofthe Surgical Incision: What Does the Future Hold-Saline,
Antibiotic Agents, or Antiseptic Agents? Surg Infect 2016; 17(6):656-664. https://doi.org/10.1089/sur.2016.158.
Khan M, Khalil J, Rooh-ul-Muqim, Zarin M, Touseef H, Ahmed N, et al. Rate and risk factors for surgical site infection at a
tertiary care facility in Peshawar, Pakistan. J Ayub Med Coll2011; 23(1): 15-18.
Motie MR, Ansari M, Nasrollahi HR. Assessment of surgical site infection risk factors at Imam Reza hospital, Mashhad, Iran
between 2006 and 2011. Med J Islam Repub Iran 2014; 28: 52.
Sanger PC, van Ramshorst GH, Mercan E, Huang S, Hartzler AL.et al. A Prognostic Model of Surgical Site Infection Using DailyClinical Wound Assessment. J Am Coll Surg 2016; 223(2): 259-270.e2. https://doi.org/10.1016/j.jamcollsurg.2016.04.046.
Bucknail TE. Factors influencing wound complications: a clinical and experimental study. Ann R Coll Surg Engl 1983: 65(2): 71-77.
Pianka F, Mihaljevic AL. Vermeidung postoperativer Infektionen:Evidenzbasierte Prinzipien [Prevention of postoperative
infections : Evidence-based principles]. Chirurg 2017; 88(5): 401-407. https://doi.org/10.1007/s00104-017-0384-5.
Alfonso-Sanchez JL, Martinez IM, Martín-Moreno JM, González RS, Botía F. Analyzing the risk factors influencing surgical siteinfections: the site of environmental factors. Can J Surg 2017;60(3): 155-161. https://doi.org/ 10.1503/cjs.017916.
Elsolh B, Zhang L, Patel SV. The Effect of Antibiotic-Coated Sutures on the Incidence of Surgical Site Infections in Abdominal Closures: a Meta-Analysis. J Gastrointest Surg 2017; 21(5): 896-903. https://doi.org/10.1007/s11605-017-3357-6.
Lv YF, Wang J, Dong F, Yang DH. Meta-analysis of local gentamicin for prophylaxis of surgical site infections in colorectal
surgery. Int J Colorectal Dis 2016; 31(2): 393-402.https://doi.org/10.1007/s00384-015-2454-9.
Totoraitis K, Cohen JL, Friedman A. Topical Approaches toImprove Surgical Outcomes and Wound Healing: A Review of
Efficacy and Safety. J Drugs Dermatol 2017; 16(3): 209-212.
Cervantes-Sánchez CR, Gutiérrez-Vega R, Vázquez-Carpizo JA,Clark P, Athié-Gutiérrez C. Syringe pressure irrigation of
subdermic tissue after appendectomy to decrease the incidenceof postoperative wound infection. World J Surg 2000; 24(1): 38-43. https://doi.org/10.1007/s002689910008.
Mueller TC, Loos M, Haller B, Mihaljevic AL, Nitsche U,Wilhelm D, et al. Intra-operative wound irrigation to reduce
surgical site infections after abdominal surgery: a systematic review and meta-analysis. Langenbecks Arch Surg 2015; 400(2):
-181. https://doi.org/10.1007/s00423-015-1279-x.
Norman G, Atkinson RA, Smith TA, Rowlands C, Rithalia AD, Crosbie EJ, et al. Intracavity lavage and wound irrigation for
prevention of surgical site infection. Cochrane Database Syst Rev 2017; 10(10): CD012234.https://doi.org/10.1002/14651858.CD012234.pub2.
Zhuo Y, Zhang Q, Tang D, Cai D. The effectiveness of i.v. cefuroxime prophylaxis of surgical site infection after elective
inguinal hernia repair with mesh: A retrospective observational study. Eur J Clin Pharmacol 2016; 72(9): 1033-1039.
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