EFFICACY OF SINGLE DOSE VERSUS MULTIPLE DOSE ANTIBIOTIC IN ELECTIVE INGUINAL HERNIA SURGERIES
Main Article Content
Keywords
.
Abstract
A hernia is an abnormal protrusion of the whole or part of a viscus through normal or abnormal opening in the walls of its containing cavity.1 Inguinal hernias are among the most common problems seen in surgical clinics. Inguinal hernias comprise 75% of all abdominal hernias.The lifetime risk of developing an inguinal hernia is 27% in males.The lifetime risk of developing an inguinal hernia is 3% in females2. They can be congenital or acquired, complete or partial, external or internal, reducible or irreducible, direct or
indirect, and primary or recurrent3. Patients typically present with a bulge in the groin that is associated with pain in twothirds of cases.4 Painful hernias are most frequently described as a dull aching, heavy, dragging, or burning sensation. Maneuvers that
increase intra-abdominal pressure, such as straining, lifting, or coughing, may exacerbate pain or hernia size by causing intra-abdominal contents to be pushed through the fascial defect5.
Some patients may complain of worsening symptoms at the end of the day or after increased activity. Minor symptomatic cases may be temporarily improved by lying down or reducing the hernia manually. Severe or unbearable pain, that is, sudden onset, suggests possible complicated hernia and should be treated as an emergency.
References
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9. Kulacoglu H. Current options in inguinal hernia repair in adult patients. Hippokratia. 2011;15(3):223-231.
10. Shukla A, Mathur RK, Sheikh Z, et al. Nbutyl-2-cyanoacrylate glue versus suture for mesh fixation in open inguinal hernioplasty. J. Evolution Med. Dent. Sci. 2019;8(48):3575-3578.
11. Hakeem A, Shanmugam V. Inguinodynia following Lichtenstein tension-free hernia repair: a review. World J Gastroenterol. 2011;17(14):1791-1796. doi:10.3748/wjg.v17.i14.1791.
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doi:10.1002/14651858.CD001543.pub4
13. Scott NW, McCormack K, Graham P, Go PM, Ross SJ, Grant AM. Open mesh versus non-mesh for repair of femoral and inguinal hernia. Cochrane Database Syst Rev. 2002;(4):CD002197. doi:10.1002/14651858.CD00219.
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33. Dr. Soundara Rajan, Aswathy Harikumar, Sreelekshmi. To assess the efficacy of single dose prophylactic antibiotics in preventing SSI after clean elective surgery. J Case Rep Sci Images 2021;3(1):01-03
34. K. Saravanan, A. Muthukumar. Prophylaxis pre-operative single dose antibiotic versus conventional antibiotic therapy in lichtenstein tension free mesh repair. International Journal of Contemporary Medicine Surgery and Radiology. 2019;4(2):B171-B173.
35. Thapa SB, Kher YR, Tambay YG. Single dose Intraoperative Antibiotics versus Postoperative Antibiotics for Patient Undergoing Laparoscopic Cholecystectomy for Symptomatic Cholelithiasis: a Randomized Clinical Trial. Journal of Lumbini Medical College. 2017 Jul 5;5(1):13-7.
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37. Chaudhary R, Sharma S, Chaudhary S, Thakur S, Shukla A, Sharma A. A prospective study comparing single with multiple antibiotic prophylaxis dose in elective cholecystectomy. Ann Int Med Den Res. 2015;1(1):29-33.
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54. Halverson K. Inguinal and Femoral Hernioplasty: A 22-Year Study of the Authors’ Methods. Arch Surg. 1970 Aug 1;101(2):127.
55. Ponka JL. Surgical management of large bilateral indirect sliding inguinal herniasAm J Surg. 1966 Jul;112(1):52–7.
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2. Brunicardi F, Andersen D, Billiar T, et al. Schwartz's principles of surgery. 10th edn. McGraw- Hill Education/Medical 2014: p. 1495-591.
3. Friedman DW, Boyd CD, Norton P, Greco RS, Boyarsky AH, Mackenzie JW, Deak SB. Increases in type III collagen gene expression and protein synthesis in patients with inguinal hernias. Ann Surg 1993;218(6): 754-760.
4. Öberg S, Andresen K, Rosenberg J. Etiology of Inguinal Hernias: A Comprehensive Review. Front Surg. 2017;4:52. Published 2017 Sep 22. doi:10.3389/fsurg.2017.00052
5. LeBlanc KE, LeBlanc LL, LeBlanc KA. Inguinal hernias: diagnosis and management. Am Fam Physician. 2013;87(12):844-848.
6. Kraft BM, Kolb H, Kuckuk B, et al. Diagnosis and classification of inguinal hernias. Surg Endosc. 2003;17(12):2021-2024. doi:10.1007/s00464-002-9283-y
7. Kulah B, Kulacoglu IH, Oruc MT, Duzgun AP, Moran M, Ozmen MM, et al. Presentation and outcome of incarcerated external hernias in adults. Am J Surg. 2001;181:101–104. [PubMed] [Google Scholar]
8. Akinci M, Ergül Z, Kulah B, Yilmaz KB, Kulacoglu H. Risk factors related with unfavorable outcomes in groin hernia repairs. Hernia. 2010;14:489–493. [PubMed] [Google Scholar]
9. Kulacoglu H. Current options in inguinal hernia repair in adult patients. Hippokratia. 2011;15(3):223-231.
10. Shukla A, Mathur RK, Sheikh Z, et al. Nbutyl-2-cyanoacrylate glue versus suture for mesh fixation in open inguinal hernioplasty. J. Evolution Med. Dent. Sci. 2019;8(48):3575-3578.
11. Hakeem A, Shanmugam V. Inguinodynia following Lichtenstein tension-free hernia repair: a review. World J Gastroenterol. 2011;17(14):1791-1796. doi:10.3748/wjg.v17.i14.1791.
12. Amato B, Moja L, Panico S, et al. Shouldice technique versus other open techniques for inguinal hernia repair. Cochrane Database Syst Rev. 2012;2012(4):CD001543. Published 2012 Apr 18.
doi:10.1002/14651858.CD001543.pub4
13. Scott NW, McCormack K, Graham P, Go PM, Ross SJ, Grant AM. Open mesh versus non-mesh for repair of femoral and inguinal hernia. Cochrane Database Syst Rev. 2002;(4):CD002197. doi:10.1002/14651858.CD00219.
14. Gaynes RP, Culver DH, Horan TC, Edwards JR, Richards C, Tolson JS. Surgical site infection (SSI) rates in the United States, 1992-1998: the National Nosocomial Infections Surveillance System basic SSI risk index. Clin Infect Dis. 2001 Sep 1;33 Suppl 2:S69-7
15. Ghafur A, Jayalaletal JA. The Chennai declaration. Indian J Cancer 2012;49:71
16. Erdas E, Medas F, Pisano G, Nicolosi A, Calò PG. Antibiotic prophylaxis for open mesh repair of groin hernia: systematic review and meta-analysis. Hernia. 2016;20(6):765-776. doi:10.1007/s10029-016-1536-0
17. Ranjan A, Singh R, Naik PC. A comparative study of single-dose preoperative antibiotic prophylaxis versus routine long-term postoperative prophylaxis in elective general surgical cases. Int J Med Sci Public Health 2016;5:1083-1087.
18. Basavarajappa M, Mathad AS, Deepak G. A Comparative Study of Effect of Single-Dose Prophylactic Antibiotic versus Conventional Antibiotic Therapy in Selected Clean Surgical Cases in A Tertiary Care Centre.
19. Basant RK, Kumar R, Pandey VK, Saxena A, Singh V, Madeshiyaa S. A comparative study of single dose preoperative antibiotic prophylaxis versus fiveday conventional postoperative antibiotic therapy in patient undergoing elective surgical procedure. International Surgery Journal. 2019 Jan 28;6(2):409-15.
20. Sumukha SR. Efficacy of single dose versus multiple dose antibiotic prophylaxis in anterior abdominal wall hernia repair at a tertiary hospital. International Journal of Surgery. 2020;4(3):230-2
21. Resident NC. Outcome of Evidence-based Allocation of Single-dose Antibiotic extended to Three- dose Antibiotic Prophylaxis in Surgical Site Infection. International Journal of Recent Surgical and Medical Sciences. 2017 Dec;3(02):079-84.
22. Shah YD, Thekdi PI, Raut S, Patel KG. Single shot versus multiple shot antibiotic therapy in patients undergoing laparoscopic surgery: our experience. Int J Res Med Sci 2013;1:252-6
23. Shaikh SA, Iqbal M. Comparison of Single Dose with Multiple Dose Antibiotic Prophylaxis with Cefuroxime in Open Cholecystectomy. Journal of Islamabad Medical & Dental College. 2012;1(1):2-5.
24. Madhu BS, HB SK, Reddy AV, Kalabhairav S. Effect of single dose pre-operative antibiotic prophylaxis versus conventional antibiotic therapy in patients undergoing lichtenstein tension free mesh repair. International Surgery Journal. 2017 Jan 25;4(2):738-42.
25. Khan GJ, KHAN RA, Rasheed A. Comparison between single and multiple days treatment with parenteral cefuroxime in inguinal hernia mesh repair surgery. Biomedica. 2013 Jul;29(3):169-74.
26. Surahio AR, Khan AA, Farooq MU, Fatima I. Single versus 3-dose antibiotic prophylaxis in clean and clean contaminated operations. Journal of Ayub Medical College Abbottabad. 2010 Dec1;22(4):91-4.
27. Garg S, Garg S, Shoaib M. Efficacy of single dose versus multiple dose antibiotic prophylaxis in clean and clean-contaminated herniorrhaphy surgery. J. Evid. Based Med. Healthc. 2018; 5(39), 2786-2789.
28. Sutariya PK, Thekdi PI. Single dose versus multiple dose prophylactic antibiotic in laparoscopic cholecystectomy: a comparative study. International Surgery Journal. 2016 Dec 8;3(2):633-6.
29. Jeong WK, Park JW, Lim SB, Choi HS, Jeong SY. Cefotetan versus conventional triple antibiotic prophylaxis in elective colorectal cancer surgery. J. Korean Med. Sci. 2010; 25(2): 429–34.
30. Borade SV, Syed O. Single dose antibiotic prophylaxis for prevention of surgical site infection in elective surgery. International Surgery Journal. 2017 Dec 26;5(1):27-33.
31. Shaheen S, Akhtar S. Comparison of single dose versus multiple doses of anitibiotic prophylaxis in elective caesarian. J Postgrad Med Inst 2014; 28(1):83-6.
32. Jayalal JA, Selwyn, Thambithurai D. Effect of Single-Dose Antibiotic Prophylaxis versus Conventional Antibiotic Therapy in Surgery: A Randomized Controlled Trial in a Public Teaching Hospital. Int J Sci Stud 2015;3(8):109-113.
33. Dr. Soundara Rajan, Aswathy Harikumar, Sreelekshmi. To assess the efficacy of single dose prophylactic antibiotics in preventing SSI after clean elective surgery. J Case Rep Sci Images 2021;3(1):01-03
34. K. Saravanan, A. Muthukumar. Prophylaxis pre-operative single dose antibiotic versus conventional antibiotic therapy in lichtenstein tension free mesh repair. International Journal of Contemporary Medicine Surgery and Radiology. 2019;4(2):B171-B173.
35. Thapa SB, Kher YR, Tambay YG. Single dose Intraoperative Antibiotics versus Postoperative Antibiotics for Patient Undergoing Laparoscopic Cholecystectomy for Symptomatic Cholelithiasis: a Randomized Clinical Trial. Journal of Lumbini Medical College. 2017 Jul 5;5(1):13-7.
36. Diwaker A, Datey A, Verma D, Bandi A. A comparative study of Single dose versus multiple doses of antibiotic prophylaxis in open inguinal hernioplasty. IOSR J Dental Med Sci. 2018;17(5):28-32.
37. Chaudhary R, Sharma S, Chaudhary S, Thakur S, Shukla A, Sharma A. A prospective study comparing single with multiple antibiotic prophylaxis dose in elective cholecystectomy. Ann Int Med Den Res. 2015;1(1):29-33.
38. Subburathinam DA, Karthick MP, Princy J. Effectiveness of single over triple dose antibiotic prophylaxis in open inguinal hernioplasty. International Journal of Surgery. 2021;5(1):297-300.
39. Javid PJ, Brooks DC. Hernias. In: Zinner MJ, Ashley SW, eds. Maingot's Abdominal operations, 11th Ed. New York: Mc Graw Hill,2007: 103-140.
40. Bell RL, Seymour NE. Abdominal wall, omentum, mesentery, retroperitoneum. Brunicardi FC, ed. Schwartz's principles of surgery, 8th Ed. New York: Mc Graw Hill, 2005:1317- 1328.
41. Haeger K. The illustrated history of Surgery. London: Harold Starke, 1988.
42. Sinnatamby Cs. Anterior abdominal wall. Last’s anatomy regional and applied, 10th ed. Churchill Livingstone, 2000; 215- 226.
43. Russell RCG, Williams NS, Bulstrode CJK. Hernias, umbilicus and abdominal wall, Bailey & Love’s – short practice of surgery, 24th ed. London, Arnold, 2004; 1272- 1293.
44. Chaurasia BD. Anterior abdominal wall, Human Anatomy Regional & Applied, 3nd Ed, CBS Publishers, 2001; 163-180.
45. Singh IB. Textbook of Anatomy with Colour Atlas. 5th ed. Delhi. jaypee Brothers; 2007. Chapter 39 p550
46. Lytle WJ. Inguinal anatomy. J Anat. 1979 May;128(Pt 3):581-94
47. Chaurasia BD. Anterior abdominal wall, Human Anatomy Regional & Applied, 3nd Ed, CBS Publishers, 2001; 163-180
48. Sinnatamby CS. Anterior abdominal wall. Last's anatomy regional and applied, 10th Ed. Churchill Livingstone, 2000; 215-226.
49. Decker GAG. The groin & scrotum. Lee Mc Gregor's Synopsis of Surgical Anatomy. 12th ed, Varghese Publishing house, 1999; 118-136.
50. Russell RCG, Williams NS, Bulstrode CJK. Hernias, umbilicus and abdominal wall. Bailey & Love's - Short practice of surgery, 25th Ed. London: Arnold, 2008; 968-
51. Read RC, Anatomy of Abdominal Herniation: The Parietoperitoneal spaces. In:Nyhus LM, Baker RJ, Fischer JE, Mastery of Surgery, 3rd ed. Little, Brown and Company, 1997; 1795-1806.
52. Javid PJ, Brooks DC. Hernias. In: Zinner MJ, Ashley SW, eds. Maingot's Abdominal operations, 11th Ed. New York: Mc Graw Hill,2007: 103-140.
53. Casten DF. Functional anatomy of the groin area as related to the classification and treatment of groin hernias. Am J Surg. 1967 Dec;114(6):894–9.
54. Halverson K. Inguinal and Femoral Hernioplasty: A 22-Year Study of the Authors’ Methods. Arch Surg. 1970 Aug 1;101(2):127.
55. Ponka JL. Surgical management of large bilateral indirect sliding inguinal herniasAm J Surg. 1966 Jul;112(1):52–7.
56. The Aachen classification of inguinal hernia [Internet].Available from: https://www.researchgate.net/publication/298655224_The_Aachen_classification_of_inguinal hernia
57. Bendavid R. Classification of inguinal hernias: The T.S.D. Classification – A Nomenclature for Groin Hernias. Surg Laparosc Endosc Percutan Tech. 1994 Dec;4(6):467.
58. Chowbey Pradeep K., et al. Complications in groin hernia surgery and the way out. Journal of minimal access surgery.2006; 3:2:174- 177
59. S Das. A manual on clinical surgery. Calcutta 13th edition 2018; 594-610.
60. S Das. A manual on clinical surgery. 4th ed. Calcutta; 1996. 428–444 p.
61. A C. Demonstration of physical signs in clinical surgery. 17th ed. 1992. 260–272.
62. NL B. An introduction to the symptoms and signs of surgical diseases. 2nd ed. ELBS; 1991. 310–321 p.
63. J A. Hernias. Maingot’s abdominal operations. 10th ed. McGraw Hill; 2001. 479580 p.
64. Devlin HB. Inguinal hernia in adults. In: Carter D, Russell RCG, Pitt HA. Atlas of General Surgery. 3rd ed. London: Arnold 1996; 38-49.
65. Farquharson M, Moran B eds. Surgery of the groin and external genitalia. In: Farquharson's Textbook of Operative General Surgery. 9th Ed. London: Edward Arnold, 2005: 459-484.
66. Farquharson M, Moran B eds. Surgery of the groin and external genitalia. In: Farquharson's Textbook of Operative General Surgery. 9th Ed. London: Edward Arnold, 2005: 459-484.
67. Shenoy KR, ed. Hernia. In: Manipal manual of surgery, 2nd Ed. New Delhi: CBS, 2005: 551-573.
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Jun 17, 2025
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Dr. Girish B. K, Dr. Harish. C, Dr. Hemand N. M, & Dr. Shibin Sankar. (2025). EFFICACY OF SINGLE DOSE VERSUS MULTIPLE DOSE ANTIBIOTIC IN ELECTIVE INGUINAL HERNIA SURGERIES. Journal of Population Therapeutics and Clinical Pharmacology, 32(5), 830-848. https://doi.org/10.53555/15bgzd45
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Author Biographies
Dr. Girish B. K
Junior resident 3rd year, Rajarajeshwari Medical College and Hospital, Bengaluru-560074, Karnataka, India.
Dr. Harish. C
Senior Resident General Surgery, Rajarajeshwari Medical College and Hospital, Bengaluru-560074, Karnataka, India.
Dr. Hemand N. M
Junior resident 3rd year, Rajarajeshwari Medical College and Hospital, Bengaluru-560074, Karnataka, India.
Dr. Shibin Sankar
Junior resident 3rd year, Rajarajeshwari Medical College and Hospital, Bengaluru-560074, Karnataka, India.
How to Cite
Dr. Girish B. K, Dr. Harish. C, Dr. Hemand N. M, & Dr. Shibin Sankar. (2025). EFFICACY OF SINGLE DOSE VERSUS MULTIPLE DOSE ANTIBIOTIC IN ELECTIVE INGUINAL HERNIA SURGERIES. Journal of Population Therapeutics and Clinical Pharmacology, 32(5), 830-848. https://doi.org/10.53555/15bgzd45