Hernia Mesh Repair of the Anterior Abdominal Wall and Antibiotic Chemoprophylaxis: Multiple Doses of Antibiotics Failed to Prevent or Reduce Wound Infection
O. Ioannidis, G. Paraskevas, I. Varnalidis, M. Ntoumpara, L. Tsigkriki, S. Gatzos, S.G. Malakozis, D. Papapostolou, A. Papadopoulou, A. Makrantonakis, N. MakrantonakisOriginal article, no. 6, 2013
Background: Mesh repair of the anterior abdominal wallhernias is a popular technique and commonly acceptedamong the majority of surgeons. The technique used mostfrequently today is the free tension technique. It is uncertainwhether antibiotic prophylaxis is necessary to prevent postoperativewound infection, especially when a foreign bodylike a polypropylene mesh is used.Methods: We have studied retrospectively the patients whoreceived surgical treatment in our department for anteriorabdominal wall hernia during the period of January 1995 -December 2004. Patients were divided into 3 groups basedon the doses of antibiotics administered.Results: In 780 out of 1245 cases, a mesh of polypropylene wasused. In our sample, we excluded 221 patients due to diseasesthat made the use of antibiotics necessary. We have studied thefrequency of superficial and deep infections in correlation with the use of antibiotics (cephalosporin of second generation or acombination of ampicillin plus sulbactam).Conclusion: No difference was observed in the incidence ofsurgical trauma infection in relation to the duration and thedoses of antibiotic cover. The wound infection rate in thecurrent study does not support the use of multiple doses ofantibiotics, as this rate does not differ from the rates ofinfection reported in the literature. Further studies areneeded to clarify if antibiotic chemoprophylaxis with onedose or no chemoprophylaxis should be recommended.
