ROLE OF PROPHYLACTIC ANTIBIOTICS IN INGUINAL HERNIA REPAIR: SYSTEMATIC REVIEW AND META ANALYSIS

Main Article Content

Sadaf Khalid
Komal Khalid
Afsar Ali Bhatti
Zahid Iqbal

Keywords

inguinal hernia repair, prophylactic antibiotics, surgical site infection, systematic review, meta-analysis

Abstract

Background: Inguinal hernia repair is a frequently performed surgical procedure, and the effectiveness of prophylactic antibiotics in preventing postoperative surgical site infections (SSIs) is a topic of ongoing investigation.


Objectives: This systematic review aims to assess the impact of prophylactic antibiotics on reducing SSIs after inguinal hernia repair through a comprehensive meta-analysis of available literature.


Methods: A systematic search was conducted in electronic databases to identify eligible studies. For this study, Preferred Reporting Items guideline for conducting this systematic review analysis (PRISMA) was followed. Electronic articles from January 2022 to April 2023 were searched on PUB Med, online Willey library, and Science Direct site. A systematic and exhaustive search of electronic databases such as PubMed, Embase, Scopus, and the Cochrane Library was conducted. The search strategy was constructed using a combination of relevant keywords and medical subject headings (MeSH) related to inguinal hernia repair, prophylactic antibiotics, surgical site infections, and associated concepts.


Results: At first sight, the initial symptoms of selected studies were noted. A systematic search of electronic databases from January 2022 to April 2023 identified a total of 25 potentially relevant articles. After title and abstract screening, 7 articles were selected for full-text review. Following the full-text assessment, 10 articles met the predefined inclusion criteria and were included in the systematic review.


Conclusion: It is concluded that our systematic review provides valuable insights into the role of prophylactic antibiotics in inguinal hernia repair. While the evidence suggests benefits in reducing SSIs, clinicians should consider patient risk profiles, antibiotic choice, and potential adverse events when making decisions.

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References

1. Tian, Jun, et al. "The Role of Prophylactic Antibiotics in Elective Inguinal Tension-free Hernia Repair: A Systematic Review and Meta-analysis." International Wound
Journal, vol. 20, no. 4, 2023, pp. 1191-1204, https://doi.org/10.1111/iwj.13978.
2. Proctor, Victoria K., et al. "Surgical Site Infections After Emergency Hernia Repair: Substudy from the Management of Acutely Symptomatic Hernia (MASH) Study." BJS
Open, vol. 7, no. 1, 2023, https://doi.org/10.1093/bjsopen/zrac155.
3. Úbeda Pascual, Amalia, et al. "Analyzing Complications and Implementing Solutions in a Pediatric Inguinal Hernia Cooperation Program in Equatorial Guinea: A Prospective Cohort Study." Annals of Pediatric Surgery, vol. 19, no. 1, 2023, pp. 1-
8, https://doi.org/10.1186/s43159-022-00237-5.
4. Llor C, Bjerrum L. Antimicrobial resistance: Risk associated with antibiotic overuse and initiatives to reduce the problem. Therapeutic advances in drug safety. 2014;5(6):229-41. https://doi.org/10.1177/2042098614554919.
5. Vatavati SR, Kampli MS. Surgeries and surgical site infection in India: An analysis of health management information system 2019-2020. J Surg Surgical Res. 2020;6(2):146-48. Doi: https://dx.doi.org/10.17352/2455-2968.000118.
6. Cheng H, Chen BP, Soleas IM, Ferko NC, Cameron CG, Hinoul P. Prolonged operative duration increases risk of surgical site infections: A systematic review. Surg Infect (Larchmt). 2017;18(6):722-35. Doi: 10.1089/sur.2017.089.
7. Kamat US, Fereirra AM, Kulkarni MS, Motghare DD. A prospective study of surgical site infections in a teaching hospital in Goa. Indian J Surg. 2008;70(3):120-24. Doi: 10.1007/s12262-008-0031-y.
8. Aeschbacher P, Nguyen TL, Dorn P, Kocher GJ, Lutz JA. Surgical site infections are associated with higher blood loss and open access in general thoracic practice. Front Surg. 2021;8:656249. Published 2021 Jun 25. Doi: 10.3389/ fsurg.2021.656249.
9. He, Linxiang, et al. "Hernia Mesh Infection Treatment following the Repair of Abdominal Wall Hernias: A Single-center Experience." Frontiers in Surgery, vol. 9, 2022, p.
993855, https://doi.org/10.3389/fsurg.2022.993855.
10. Zhang M, Ma XY, Feng ZQ, Gao L. Survey of antibiotic use among hospitalised children in a hospital in Northeast China over a 4‐year period. J Spec Pediatr Nurs 2020;25(2):e12282.
11. Usman, Muhammad, Yasir Hameed, and Mukhtiar Ahmad. "Does epstein–barr virus participate in the development of breast cancer? A brief and critical review with molecular evidences." Biomedical and Biotechnology Research Journal (BBRJ) 4, no. 4 (2020): 285.
12. Hameed, Yasir, and Samina Ejaz. "TP53 lacks tetramerization and N-terminal domains due to novel inactivating mutations detected in leukemia patients." Journal of Cancer Research and Therapeutics 17, no. 4 (2021): 931-937.
13. Karellis A, Vaillancourt J, Sampalis J: Development of risk-index tool to predict Surgical site infections. SOJ Surg. 2015, 2:1-10. 10.15226/2376-4570/2/2/00116
14. Goyal, A., Garg, R., Jenaw, R. K., & Jindal, D. K. (2011). Role of prophylactic antibiotics in open inguinal hernia repair: a randomised study. Indian Journal of Surgery, 73(3), 190-193.
15. Ullah, Lateef, Yasir Hameed, Samina Ejaz, Anam Raashid, Jamshed Iqbal, Inam Ullah, and Syeda Abida Ejaz. "Detection of novel infiltrating ductal carcinoma-associated BReast CAncer gene 2 mutations which alter the deoxyribonucleic acid-binding ability of BReast CAncer gene 2 protein." Journal of Cancer Research and Therapeutics 16, no. 6 (2020): 1402-1407.
16. Hameed, Abdul, Carla Condò, Isfahan Tauseef, Maryam Idrees, Shakira Ghazanfar, Arshad Farid, Muhammad Muzammal et al. "Isolation and characterization of a cholesterol-lowering bacteria from Bubalus bubalis raw milk." Fermentation 8, no. 4 (2022): 163.
17. Johanet, H., & Contival, N. (2011). Mesh infection after inguinal hernia mesh repair. Journal of visceral surgery, 148(5), e392-e394.
18. Zamkowski, M. T., Makarewicz, W., Ropel, J., Bobowicz, M., Kąkol, M., & Śmietański, M. (2016). Antibiotic prophylaxis in open inguinal hernia repair: a literature review and summary of current knowledge. Videosurgery and Other Miniinvasive Techniques, 11(3), 127-136.
19. Sanabria, A., Domínguez, L. C., Valdivieso, E., & Gómez, G. (2007). Prophylactic antibiotics for mesh inguinal hernioplasty: a meta-analysis. Annals of surgery, 245(3), 392.
20. Boonchan, T., Wilasrusmee, C., McEvoy, M., Attia, J., & Thakkinstian, A. (2017). Network meta-analysis of antibiotic prophylaxis for prevention of surgical-site infection after groin hernia surgery. Journal of British Surgery, 104(2), e106-e117