BACKGROUND: Identification of subgroups of patients at high and low risk for global infectious complications (GIC) after inguinal hernia repair without mesh. METHODS: A database of 1254 patients who underwentinguinal hernia repair without mesh, issued from 3 prospective multicenter randomized trials, has been established (group A). After multivariate analysis, a score for GIC was calculated and tested using data from a similar prospective randomized multicenter study (group B). RESULTS: A risk score for GIC was constructed: -4.7 + (0.95 x age > or =75 years) + (1.1 obesity) + (2.1 x urinary catheter). In case of score less than -4.2 (low-risk group), the GIC rate was 2.7%; therefore, in case of score more than -4.2 (high-risk score), the GIC rate was 14.3% (P < .001). In the low-risk group, the administration of antibiotic prophylaxis did not reduce the infectious complication rate, while in high-risk group the administration of antibiotic prophylaxis significantly reduced the rates of surgical site infection, GIC, and urinary infection by 72%, 67%, and 76.8%, respectively. CONCLUSIONS: This study demonstrates the efficacy of antibiotic prophylaxis in inguinal hernia surgery in the subgroup of high-risk patients.
RCT Entities:
BACKGROUND: Identification of subgroups of patients at high and low risk for global infectious complications (GIC) after inguinal hernia repair without mesh. METHODS: A database of 1254 patients who underwent inguinal hernia repair without mesh, issued from 3 prospective multicenter randomized trials, has been established (group A). After multivariate analysis, a score for GIC was calculated and tested using data from a similar prospective randomized multicenter study (group B). RESULTS: A risk score for GIC was constructed: -4.7 + (0.95 x age > or =75 years) + (1.1 obesity) + (2.1 x urinary catheter). In case of score less than -4.2 (low-risk group), the GIC rate was 2.7%; therefore, in case of score more than -4.2 (high-risk score), the GIC rate was 14.3% (P < .001). In the low-risk group, the administration of antibiotic prophylaxis did not reduce the infectious complication rate, while in high-risk group the administration of antibiotic prophylaxis significantly reduced the rates of surgical site infection, GIC, and urinary infection by 72%, 67%, and 76.8%, respectively. CONCLUSIONS: This study demonstrates the efficacy of antibiotic prophylaxis in inguinal hernia surgery in the subgroup of high-risk patients.
Authors: Tyler J Loftus; Kristina L Go; Janeen R Jordan; Chasen A Croft; R Stephen Smith; Frederick A Moore; Philip A Efron; Alicia M Mohr; Scott C Brakenridge Journal: J Trauma Acute Care Surg Date: 2017-07 Impact factor: 3.313
Authors: Claudia C Orelio; Coen van Hessen; Francisco Javier Sanchez-Manuel; Theodorus J Aufenacker; Rob Jpm Scholten Journal: Cochrane Database Syst Rev Date: 2020-04-21
Authors: Joseph S Fernandez-Moure; Jeffrey L Van Eps; Jacob C Scherba; Seth Haddix; Megan Livingston; Nathan S Bryan; Concepcion Cantu; Chandni Valson; Francesca Taraballi; Lewis J Kaplan; Randall Olsen; Ennio Tasciotti Journal: Surg Infect (Larchmt) Date: 2021-04-30 Impact factor: 1.853