Alvaro Sanabria1, Luis Carlos Domínguez, Eduardo Valdivieso, Gabriel Gómez. 1. Grupo Colaborativo de Epidemiología Quirúrgica, Department of Surgery, School of Medicine, Pontificia Universidad Javeriana-Hospital, Universitario San Ignacio, Bogotá, Colombia. alvarosanabria@gmail.com
Abstract
OBJECTIVE: To assess the effectiveness of antibiotic prophylaxis in mesh hernioplasty. BACKGROUND: Antibiotic prophylaxis use in mesh inguinal hernioplasty is controversial. Available evidence is nonconclusive because of the low number of clinical trials assessing its effectiveness. Some trials have a small sample size that could overestimate or underestimate the real effectiveness of this intervention. Meta-analysis is a good method to improve these methodological flaws. METHODS: Meta-analysis intended to measure the benefits of antibiotic prophylaxis on surgical site infection rate in adult patients scheduled for mesh inguinal hernioplasty. Six randomized clinical trials were found. Quality was assessed using Cochrane Collaboration criteria. RESULTS: A total of 2507 patients were analyzed. Surgical site infection frequency was 1.38% in the antibiotic group versus 2.89% in the control group (odds ratio = 0.48; 95% confidence interval, 0.27-0.85). There was no statistical heterogeneity. Sensitivity analysis by quality did not show differences in overall results. CONCLUSION: Antibiotic prophylaxis use in patients submitted to mesh inguinal hernioplasty decreased the rate of surgical site infection by almost 50%.
OBJECTIVE: To assess the effectiveness of antibiotic prophylaxis in mesh hernioplasty. BACKGROUND: Antibiotic prophylaxis use in mesh inguinal hernioplasty is controversial. Available evidence is nonconclusive because of the low number of clinical trials assessing its effectiveness. Some trials have a small sample size that could overestimate or underestimate the real effectiveness of this intervention. Meta-analysis is a good method to improve these methodological flaws. METHODS: Meta-analysis intended to measure the benefits of antibiotic prophylaxis on surgical site infection rate in adult patients scheduled for mesh inguinal hernioplasty. Six randomized clinical trials were found. Quality was assessed using Cochrane Collaboration criteria. RESULTS: A total of 2507 patients were analyzed. Surgical site infection frequency was 1.38% in the antibiotic group versus 2.89% in the control group (odds ratio = 0.48; 95% confidence interval, 0.27-0.85). There was no statistical heterogeneity. Sensitivity analysis by quality did not show differences in overall results. CONCLUSION: Antibiotic prophylaxis use in patients submitted to mesh inguinal hernioplasty decreased the rate of surgical site infection by almost 50%.
Authors: Theo J Aufenacker; Dirk van Geldere; Taco van Mesdag; Astrid N Bossers; Benno Dekker; Edo Scheijde; Roos van Nieuwenhuizen; Esther Hiemstra; John H Maduro; Jan-Willem Juttmann; Diederik Hofstede; Cunera T M van Der Linden; Dirk J Gouma; Maarten P Simons Journal: Ann Surg Date: 2004-12 Impact factor: 12.969
Authors: David Earle; J Scott Roth; Alan Saber; Steve Haggerty; Joel F Bradley; Robert Fanelli; Raymond Price; William S Richardson; Dimitrios Stefanidis Journal: Surg Endosc Date: 2016-07-12 Impact factor: 4.584