Complicaciones postoperatorias en la herniorrafia ambulatoria con malla. Estudio comparativo de la tasa de infección del sitio operatorio con y sin profilaxis antibiótica

Abstract

The use of antibiotic prophylaxis has been questioned in the inguinal herniorrhaphy with mesh. The aim of this paper is to give account of the efficiency of antibiotic prophylaxis (AP) in the prevention of wound infection in the elective inguinal herniorrhaphy with mesh under local anaesthesia in an ambulatory basis. In the present observacional analytic study, 955 patients were operated upon with a mesh technique during a 10 year period, in the CRS Hernia Centre in Santiago. In the first group of 250 patients, 1 gr Cefazolin (R) was administered iv one hour before the operation, in the second group of 710 patients no antibiotics were used. Demographic variables, associated diseases, the length of surgery were comparable in both groups. The same team of surgeons work in both groups. Wound infection was defined as the presence of pus in the surgical wound associated with a positive bacterial culture. The rate of wound infections was 1.05% of the first and 0.35% of the second group. This difference was no significant (p < 0.08). The isolated germ was a Staphylococcus aureus in all cases. The treatment was ambulatory in all cases. The rate of haematoma and funiculotesticular fluxion were low. We conclude that the rate of wound infection in mesh hemiorrhaphies is low and that the antibiotic prophylaxis does not improve these results. Its routine use in these patients is not justified.