Using antibiotic prophylaxis to reduce surgical site infection after shouldice repair

The administration of an antibiotic prophylaxis prior to Lichtenstein inguinal hernia repair is common. There is some scientific evidence supporting the use of prophylactic antibiotics as it can lower the rate of surgical site infections. The benefit prior to Shouldice Repair has not been previously investigated, thus, the study at hand was conducted to evaluate the benefit of an antibiotic prophylaxis in reducing surgical site infection (SSI) after Shouldice primary inguinal hernia Repair (SPIHR).

From July 2023 to August 2024 a prospective observational study was conducted at the Shouldice Hospital. The data of 2,000 consecutively enrolled eligible individuals who underwent SPIHR were analyzed. The primary objective was the rate of SSI at 30 days. As a hospital policy the administration of an antibiotic prophylaxis is the surgeon's choice. The endpoint assessment consisted of an emailed questionnaire and a telephone call from one general surgeon in the event of an SSI.

The study population was made up of mostly males (average age of 62.10 ± 12.82 years and body mass index of 24.94 ± 2.49 kg/m²). A total of 1,390 individuals received an antibiotic prophylaxis whereas 610 did not. The baseline characteristics, including morbidity and smoking status, did not differ between the groups. Receiving antibiotics was associated with significantly lower SSI rates compared to those individuals that did not receive antibiotics (n = 12/610, 2.0% versus n = 6/1,390, 0.4%; p < 0.001).

The overall SSI rate detected 30 days after SPIHR was 0.9%. Administration of an antibiotic prophylaxis prior to SPIHR lowers the rate of SSI at Shouldice Hospital.