Infection in inguinal hernia repair considering biomaterials and antibiotics.

Synthetic biomaterials have been incriminated for promoting wound infection. Perioperative antibiotics have received praise for reducing the rate of infection after certain operations. These claims were tested in a cooperative multicenter prospective study of 2,493 inguinal hernia repairs. This study was done to examine the effect of prophylactic antibiotics in primary and recurrent inguinal hernia repaired with synthetic biomaterials. Clinical signs and symptoms of wound infection and the results of each infected repair are reported. The rate of infection was about 1 percent, whether or not biomaterials or antibiotics were used. More than 70 percent of wound infections occurred in patients 60 years of age or older. Removal of biomaterials from the infected wounds was not necessary and generally is not recommended. Recurrence has not occurred in any of the infected repairs. With or without prosthetic repair, the treatment of infected inguinal hernia wounds was relatively simple, of reasonable cost and concluded with a good result. The expense incurred for routine prophylactic antibiotic treatment in inguinal hernia operation could not be reconciled by any benefits obtained.