Jornal de doenças infecciosas e terapia

Abstrato

Preventing Surgical Site Infection after Lichtenstein Inguinal Hernioplasty: Preliminary Result about Local versus IV Antibiotics Prophylaxis from a Low-Income Country University Hospital

Patrick Charlorin and Paul Reginald Cadet

Background: Preventing Surgical Site Infection (SSI) after Liechtenstein hernioplasty is an important step in the
management of inguinal hernia. In this study, we present the preliminary result about the use of IV ceftriaxone
prophylaxis vs. the local mesh-soaked gentamicin prophylaxis for the prevention of SSI after Liechtenstein
hernioplasty.
Method: We conducted a randomized controlled study in 2014, at the state university hospital. We evaluated the
occurrence of SSI on 44 patients with an inguinal hernia who underwent an elective Liechtenstein repair using a
polypropylene mesh. 13 patients received IV ceftriaxone prophylaxis. The remaining 31 received local mesh-soaked
gentamicin prophylaxis. The patients were followed for infection and other complications by an independent surgeon
on days 3, 10 and 30.
Results: The mean age of our patients was 48 years old for the IV prophylaxis group and 44 years old for the
local prophylaxis group. 9 patients had their hernia located on the right side in the IV prophylaxis group while 32
patients had right inguinal hernia for the local prophylaxis group. 30, 6% of our patients had associated conditions in
the IV prophylaxis group vs.13% in the local prophylaxis group. We found no SSI at the time of the study for either
the IV or local prophylaxis group. One case of inguinal pain was observed in the local prophylaxis group.
Conclusion: This study indicates that local mesh-soaked gentamicin prophylaxis is as effective as IV ceftriaxone
prophylaxis in preventing surgical site infection after Liechtenstein hernioplasty. But further evidence needs to be
established.