Topical antibiotic prophylaxis in Lichtenstein hernia repair and comparison of three methods: A prospective randomized clinical trial

Abstract

INTRODUCTION: Lichtenstein hernia repair is a clean surgical intervention and one of the most frequently applied operation worldwide. Despite guidelines, benefit of antibiotic prophylaxis in hernia surgery has been considered questionable and prophylaxis usage is not infrequent. Here, in this clinical randomized trial, we aimed to compare three different prophylaxis regimens to find out which one is more effective. METHODS: In this prospective study, patients were divided into three groups. First group (G1) received cefazoline, second group (G2) received topical gentamicin, and third group (G3) received combination of cefazoline and topical gentamicin. On 1st, 7th, and 30th postoperative days, surgical sites were examined for the signs of infection according to the definitions of Centers for Disease Control. Furthermore, effectiveness of infection prevention in patients with comorbid diseases was also analyzed. RESULTS: Totally 276 patients were analyzed. In G1 three, in G2 two, and in G3 0 infections were recorded. Total, infection rate was 1.8%. There was no any difference in infection rates between three groups (P = 0.285). Comorbidities did not rise infection rates under prophylaxis coverage (P > 0.05). CONCLUSION: All three methods are equally effective in surgical site infection, but combination method seems better with “0” ratio. Prophlaxy coverage also prevents surgical site infection even in the presence of risk (comorbidities).