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Antibiotic prophylaxis in umbilical and incisional hernia repair: a prospective randomised study
D Abramov1, I Jeroukhimov, A M Yinnon
1Department of Surgery A and B, Shaare Zedek Medical Center, Jerusalem, Israel.
Insights
Preoperative antibiotic prophylaxis significantly reduced overall wound infection rates following hernia repair surgery. This single-dose antibiotic regimen appears beneficial for both umbilical and incisional hernia procedures.
Area of Science:
- Surgical infection prevention
- Antibiotic prophylaxis efficacy
- Hernia repair outcomes
Background:
- Surgical site infections (SSIs) are a significant complication after hernia repair.
- Optimizing prophylactic strategies is crucial for improving patient outcomes.
- Evidence for antibiotic prophylaxis in elective hernia repair remains debated.
Purpose of the Study:
- To evaluate the effectiveness of preoperative antibiotic prophylaxis in reducing infection rates.
- To assess the impact of a single dose of cefonicid on wound infections after umbilical and incisional hernia repair.
Main Methods:
- A randomized controlled trial was conducted.
- 35 patients undergoing umbilical or incisional hernia repair were included.
- Alternate patients received a single intravenous dose of 1g cefonicid 30 minutes preoperatively.
Main Results:
- The overall wound infection rate was significantly lower in the antibiotic prophylaxis group (1/17) compared to the control group (8/18; p=0.02).
- While not statistically significant for individual hernia types, infection rates trended lower with prophylaxis for both incisional (0/8 vs 4/8) and umbilical (1/9 vs 4/10) repairs.
- Patient demographics and surgical factors were comparable between groups.
Conclusions:
- A single preoperative dose of cefonicid antibiotic prophylaxis demonstrates a beneficial effect on reducing wound infection rates after hernia repair.
- This prophylactic approach warrants consideration in surgical protocols for umbilical and incisional hernia repair.
Objective:
To find out if preoperative prophylaxis would reduce infection rates after umbilical and incisional hernia repair.
Design:
Randomised controlled trial.
Setting:
Teaching hospital, Israel.
Subjects:
35 Patients who presented with umbilical (n = 19) or incisional (n = 16) hernias during a period of 8 months.
Interventions:
Cefonicid 1 g was given by intravenous infusion to alternate patients 30 minutes before the operation.
Main Outcome Measures:
Wound infection.
Results:
The groups were comparable for age, body mass index, grade of surgeon, operating time, and size of hernial ring. The wound infection rates were 0/8 compared with 4/8 for incisional hernia repairs (p = 0.08) and 1/9 compared with 4/10 for umbilical hernia repairs (p = 0.3). The overall rate was 1/17 compared with 8/18 (p = 0.02).
Conclusions:
Single dose antibiotic puphylaxis seems to exert a beneficial effect on the wound infection rate after umbilical and incisional hernia repair.