Comparative study of Prophylactic Single Dose Antibiotic Vs Conventional Full Course Antibiotics in Hernioplasty Surgeries

Prabu, C (2019) Comparative study of Prophylactic Single Dose Antibiotic Vs Conventional Full Course Antibiotics in Hernioplasty Surgeries. Masters thesis, Madurai Medical College, Madurai.


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INTRODUCTION: Inguinal hernia is one of the most common surgical procedures done in elective theatres. Hernia is a protrusion of a viscus through an abnormal opening in the walls of the cavity containing it. About 80% of hernia occurs in groin. Inguinal hernia is the most common of all. Inguinal hernias can be congenital or acquired. Congenital hernias usually occur when there is impedance in normal developmental process rather than an acquired weakness. This is because of patent processus vaginalis (PPV) and this explains the higher incidence of congenital hernias in preterm babies. Acquired hernia can be direct, indirect or combination of both. There are many causes of hernia. It is mulifactorial disease process. The basic pathology in hernia is a weak abdominal wall and an excessive increase in pressure leading to henia formation. Among the open mesh repair procedures Lichtenstein technique is the most frequently performed technique. Lichtenstein repair for inguinal hernia is a tension free strengthening of posterior inguinal floor using polypropylene mesh also proven that recurrence of hernia is very low with mesh repair. AIMS OF THE STUDY: To Assess The Efficacy Of Antibiotics in prevention of SSI By A Comparative Study of Prophylactic Single Dose Antibiotic Vs Conventional Full Course Antibiotics In Hernioplasty Surgeries. OBJECTIVES: To assess the effectiveness of prophylactic single dose antibiotic vs conventional full course antibiotics in hernioplasty surgeries by evaluating for surgical site infections. MATERIALS AND METHODS: Study Design: It is a prospective comparitive study. All patients with inguinal hernia were involved in this study. Various parameters were assessed and wound infection assesment done. The results of both case and control group studied and the efficacy determined. Period of Study: 1 YEAR (October 2017 – September 2018) Place OF Study: Government Rajaji Hospital, Madurai. Selection of Study Subjects: All patients diagnosed with inguinal hernia willing for lichtenstien hernioplasty surgery. Sample Size: 100 patients. Data Collection: Data regarding history, clinical examination,laboratory values & postoperative analysis. Proforma containing patient history, clinical examination, investigations, Informed consent forms..Injectable cephalosporins -1gm ceftriaxone, multivitamin infusion. METHODS: Prospective comparitive study. ELIGIBILITY CRITERIA: Inclusion Criteria: 1. Patients With Unilateral ,Bilateral Primary Or Recurrent Hernia, 2. More Than 18 Years of Age. Exclusion Criteria: 1. Patients With immunosupressed states, comorbidities like DM, or patient on drugs like steroids, or associated with malignant disease. 2. Local infection In Incision Site prior to surgeries Like Tinea Corporis. 3. Complicated Hernia like those with Obstruction and hernia which are Strangulated. 4. Significant Renal Impairment,Severe Hepatic Disease, Allergic To Cephalosporins. 5. Pt Not Willing For Surgery. CONCLUSION: Thus we come to a conclusion that for a clean surgery of hernia repair, the use of conventional antibiotics does not cause a significant reduction in the rate of surgical site infection. Also in literature, it is nowhere established that conventional antibiotics for clean surgeries in general surgery reduce the infection rate as in clean contaminated and contaminated surgeries where its role is extensively studied and its reduction in rate of surgical site infection is strongly established. As this study involved only a smaller group of patients from a single institution the effect of operating room and the surgeon leading to bias could not be evaluated. Thus to conclude, according to this study performed even though it proves beyond doubt that prophylactic antibiotic during intraoperative period is no inferior to conventional antibiotics with a non significant p value , a larger study population with longer duration of study in multiple setups is needed to substantiate the outcome which states that conventional antibiotics has no added benefit in preventing Surgical site infection in hernia surgeries.

Item Type: Thesis (Masters)
Uncontrolled Keywords: Prophylactic Single Dose Antibiotic, Conventional Full Course Antibiotics, Hernioplasty Surgeries.
Subjects: MEDICAL > General Surgery
Depositing User: Subramani R
Date Deposited: 03 Sep 2019 23:35
Last Modified: 06 Sep 2019 08:02

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