Abstract
Background
The aim was to determine whether systemic antibiotic prophylaxis prevented wound infection after repair of abdominal wall hernia with mesh.
Methods
This was a systematic review of the available literature identified from multiple databases using the terms βherniaβ and βantibiotic prophylaxisβ. Randomized placebo-controlled trials of antibiotic prophylaxis in abdominal wall mesh hernia repair with explicitly defined wound infection criteria and a minimum follow-up of 1 month were included. After independent quality assessment and data extraction, data were pooled for meta-analysis using a random-effects model.
Results
The search process identified eight relevant trials. Two papers on umbilical, incisional or laparoscopic hernias, and six concerning inguinal and femoral (groin) hernias were suitable for meta-analysis. The incidence of infection after groin hernia repair was 38 (3Β·0 per cent) of 1277 in the placebo group and 18 (1Β·5 per cent) of 1230 in the antibiotic group. Antibiotic prophylaxis did not significantly reduce the incidence of infection: odds ratio 0Β·54 (95 per cent confidence interval 0Β·24 to 1Β·21); number needed to treat was 74. The number of deep infections was six (0Β·6 per cent) in the placebo group and three (0Β·3 per cent) in the antibiotic prophylaxis group: odds ratio 0Β·50 (95 per cent c.i. 0Β·12 to 2Β·09).
Conclusion
Antibiotic prophylaxis did not prevent the occurrence of wound infection after groin hernia surgery. More trials are needed for complete evidence in other areas of abdominal wall hernia.