Infection control in a hernia clinic: 24 year results of aseptic and antiseptic measure implementation in 4,620...

Area of Science:

• Surgical Infection Prevention
• Hernia Repair Outcomes
• Antimicrobial Prophylaxis

Background:

• Post-mesh herniorrhaphy infection (PMHI) presents a significant morbidity risk, with rates of 3-4% for inguinal and 8-14% for ventral repairs.
• Pre-intervention infection rates at the facility were approximately 5% for clean inguinal and 8% for clean ventral herniorrhaphies.

Purpose of the Study:

• To evaluate the effectiveness of a comprehensive infection control strategy in preventing surgical site infections after herniorrhaphy.
• To assess the long-term impact of enhanced aseptic techniques and antibiotic prophylaxis on PMHI rates.

Main Methods:

• Implementation of a stricter operative aseptic protocol.
• Per-operative administration of intravenous Cefazolin (1g).
• Wound irrigation with a solution of Gentamycin Sulphate (80mg in 250ml Normal Saline).

Main Results:

• Over 25 years, 4300 clean inguinal and 320 clean ventral herniorrhaphies were performed using the new protocol.
• No post-mesh herniorrhaphy infections were recorded after the implementation of the aseptic and antiseptic measures.
• The combined strategy demonstrated complete elimination of wound infections in clean herniorrhaphy cases.

Conclusions:

• Rigorous aseptic operating room routine combined with intravenous and topical antibiotics is highly effective in preventing wound infections.
• This protocol has successfully eliminated infections in clean herniorrhaphy cases.
• The findings support the widespread adoption of this multi-faceted approach to reduce PMHI.