Department of General Surgery, Tanta University, Tanta, Egypt.
Hernia. 2011 Jun;15(3):309-13. doi: 10.1007/s10029-011-0783-3. Epub 2011 Jan 23.
Assessment of the usefulness of antibiotic prophylaxis in inguinal hernioplasty.
This prospective randomized double blind study was conducted on 98 patients. Group A (50 patients) received a single dose of intravenous amoxicillin and clavulanic acid, and Group P (48 patients) received an equal volume of normal saline placebo by intravenous bolus 30 min before the induction of anesthesia. Hernioplasty was performed with polypropylene mesh. Skin was closed using skin staples that were removed after complete wound healing. The surgical site infection was diagnosed according to APIC, CDC criteria ( http://www.apic.org ).
The mean operative time was 38.8 ± 10.8 min in group A versus 40.9 ± 11.1 min in group P (P = 0.34). The mean hospitalization time was 1.3 ± 0.463 days in group A versus 1.25 ± 0.438 days in group P (P = 0.58). Four patients (2%) in group A and 6 patients (2.88%) in group P had wound infections (P = 0.47). Group A had 3 superficial infections and 1 deep infection while group P had 5 superficial infections and 1 deep infection. Antibiotic treatment of the wound infection was successful in all patients. Wound culture showed Staphylococcus aureus infection in 1 patient each group, Streptococcus pyogenes in 1 group A patient and Pseudomonas aeruginosa in 1 group P patient. Cultures in other patients in both groups were reported to be sterile.
Prophylactic antibiotic usage in patients undergoing tension free inguinal hernioplasty did not show any statistically significant beneficial effects in reduction of surgical site infection.
评估腹股沟疝修补术中预防性使用抗生素的效果。
这是一项前瞻性随机双盲研究，共纳入 98 例患者。A 组（50 例）患者在麻醉诱导前 30 分钟静脉注射单次剂量阿莫西林克拉维酸钾，P 组（48 例）患者静脉注射等容量生理盐水安慰剂。使用聚丙烯网片进行疝修补术。皮肤采用皮肤钉合线缝合，待伤口完全愈合后拆除。根据 APIC、CDC 标准（http://www.apic.org）诊断手术部位感染。
A 组的平均手术时间为 38.8 ± 10.8 分钟，P 组为 40.9 ± 11.1 分钟（P = 0.34）。A 组的平均住院时间为 1.3 ± 0.463 天，P 组为 1.25 ± 0.438 天（P = 0.58）。A 组有 4 例（2%）和 P 组有 6 例（2.88%）患者发生伤口感染（P = 0.47）。A 组有 3 例浅表感染和 1 例深部感染，P 组有 5 例浅表感染和 1 例深部感染。所有患者的伤口感染均经抗生素治疗成功治愈。每组各有 1 例患者的伤口培养显示金黄色葡萄球菌感染，A 组 1 例患者的链球菌感染和 P 组 1 例患者的铜绿假单胞菌感染。两组其他患者的培养结果均为无菌。
在无张力腹股沟疝修补术中预防性使用抗生素并不能显著降低手术部位感染的发生率。
