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Antibiotic prophylaxis in incisional hernia repair using a prosthesis
A Ríos1, J M Rodríguez, V Munitiz
1Department of General and Digestive Surgery, Virgen de la Arrixaca University Hospital, El Palmar, Murcia, Spain. ARZRIOS@teleline.es
Insights
Antibiotic prophylaxis significantly reduces surgical site infections in patients undergoing incisional hernia repair with prosthetic material. This finding supports the use of antibiotics to prevent complications in such procedures.
Area of Science:
- Surgical Infection Prevention
- Hernia Repair Outcomes
- Prosthetic Material Use
Background:
- Antibiotic prophylaxis is standard in clean surgery with prosthetic implants.
- Evidence for its use in abdominal incisional hernia repair is lacking.
- Incisional hernias often require prosthetic material for repair.
Purpose of the Study:
- To evaluate the efficacy of antibiotic chemoprophylaxis in incisional herniorrhaphy.
- To determine if antibiotic prophylaxis reduces surgical wound infections in this specific procedure.
- To analyze risk factors associated with infection in patients undergoing incisional hernia repair with prosthetics.
Main Methods:
- Prospective non-randomized study (1990-1998) of 216 patients.
- Analysis of patients undergoing abdominal incisional hernia repair with polypropylene prosthesis.
- Comparison of infection rates between patients who received and did not receive antibiotic prophylaxis.
Main Results:
- Surgical wound infection occurred in 18.1% of patients (39/216).
- Patients receiving antibiotic prophylaxis had a lower infection rate (13.6%) compared to those who did not (26.3%).
- Multivariate analysis identified antibiotic prophylaxis and number of risk factors as significant predictors of infection.
Conclusions:
- Antibiotic chemoprophylaxis is effective in reducing local septic complications in abdominal incisional herniorrhaphy with prosthetic material.
- The findings support the routine use of antibiotic prophylaxis in these procedures.
- Risk factor assessment alongside antibiotic use can further optimize infection prevention strategies.
Abstract:
Antibiotic prophylaxis in clean surgery with implantation of prosthetic material is widely accepted, although there are no studies on its use in abdominal incisional hernia repair. The objective was to evaluate antibiotic chemoprophylaxis in incisional herniorrhaphy with the implantation of prosthetic material. A prospective non-randomized study (1990-1998) was conducted to analyse 216 patients undergoing surgery for abdominal incisional hernia who required a prosthesis (polypropylene) in the reconstruction and who met the criteria for clean surgery. Risk factors were observed in 31.5%, the most frequent being diabetes and obesity. The incisional hernia was located mostly in the abdominal midline and in 64.4% measured over 10 cm. Antibiotic prophylaxis was administered in 140 patients (64.8%) via the systemic route, the antibiotics being first- or second-generation cephalosporins or amoxicillin-clavulanic acid. Surgical wound infection occurred in 39 patients (18.1%), 19 who had received antibiotic prophylaxis (13.6%) and 20 who had not (26.3%). In multivariate analysis using logistic regression, the variables with statistical significance for local septic infection were antibiotic prophylaxis and number of risk factors. We can conclude therefore that antibiotic chemoprophylaxis is useful in abdominal incisional herniorrhaphy surgery with implantation of prosthetic material for reducing local septic complications.
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