Do We Need Preoperative Antibiotics in Common General Pediatric Surgery Procedures?

Area of Science:

• Pediatric Surgery
• Infectious Disease Prevention

Background:

• Limited research exists on the necessity of preoperative antibiotics for pediatric surgeries like undescended testis (UDT), inguinal hernia (IH), and umbilical hernia (UH).
• Surgical site infection (SSI) is a potential complication in these procedures.

Purpose of the Study:

• To investigate the association between preoperative antibiotic use and SSI incidence in pediatric UDT, IH, and UH surgeries.
• To evaluate the risk of SSI in specific surgical types and compare antibiotic prophylaxis outcomes.

Main Methods:

• Retrospective analysis of medical records for 926 pediatric patients undergoing UDT, IH, or UH surgery.
• Comparison of SSI rates between patients who received and did not receive preoperative antibiotics.
• Subdivision of IH surgeries into open IH (OIH) repair and laparoscopic percutaneous extraperitoneal closure (LPEC).

Main Results:

• Overall SSI rates were low across all procedures (UDT/UH: 0.2%, OIH: 2.7%, LPEC: 0.3%).
• No significant difference in SSI rates was observed between patients who received or did not receive preoperative antibiotics for UDT, OIH, and LPEC.
• Patients undergoing UH surgery showed a statistically significant 9.8-fold increased relative risk of SSI compared to inguinal region surgeries.

Conclusions:

• Preoperative antibiotic prophylaxis is not indicated for pediatric UDT and OIH repair surgeries.
• Umbilical hernia (UH) surgery in children presents a high risk for SSI, necessitating enhanced perioperative care and attention.