Surgical Site Infection with and without Prophylatic Antibiotic in Children undergoing Elecltive Inguinal Herniotomy
Objective: This study was aimed at determining the frequency of surgical site infection in children undergoing elective inguinal herniotomy with and without prophylactic antibiotic.
Study design: Prospective comparative study.
Settings: Pediatric surgery Department, Ghulam Muhammad Mahar Medical College Sukkur.
Study duration: From 1st February 2020 to 31th March 2021.
Methodology: One hundred and sixty patients selected for this study and were equally divided into two groups. Group A received antibiotic prophylaxis (Injection ceftriaxone 50mg/kg) before the induction of general anesthesia, whereas Group P received placebo before the induction of general anesthesia. Demographic data and duration of surgery was noted on a proforma. Surgical procedure was carried out following standard surgical protocols. Post-operatively all patients were observed by an independent observer. Patients were observed for post-operative fever, inflammation of the surgical site and discharge from the site of incision. Wound was examined on 1st, 3rd, 7th and 30th post-operative day. For labeling Surgical Site Infection, Center of Disease criteria was followed.
Results: Demographic data of both groups was comparable. Mean duration of surgery in group A was 29.61±7.47 minutes, while it was 32.97±8.73 minutes in group P with p-value of 0.08. Out of 160 patients, thirteen patients developed surgical site infection; 5 (6.25%) patients belonged to group A, while 8 (10%) belonged to group P with a p-value of 0.385.
Conclusion: It is concluded in our study that use of prophylactic antibiotics in elective herniotomy cases performed in pediatric patients do not significantly decrease the incidence of Surgical Site Infection.
2. 1. Legesse Laloto T, Hiko Gemeda D, Abdella S. Incidence and predictors of surgical site infection in Ethiopia: prospective cohort. BMC Infectious Diseases. 2017;17(1). https://doi.org/10.1186/s12879-016-2167-x.
3. Mujagic E, Zeindler J, Coslovsky M, Hoffmann H, Soysal SD, Mechera R et al. The association of surgical drains with surgical site infections – A prospective observational study. The American Journal of Surgery. 2019;217(1):17-23. doi:10.1016/j.amjsurg.2018.06.015.
4. Ma T, Lu K, Song L, Wang D, Ning S, Chen Z et al. Modifiable factors as current smoking, Hypoalbumin, and elevated fasting blood glucose level increased the SSI risk following elderly hip fracture surgery. Journal of Investigative Surgery. 2019; 33(8):750-758. doi:10.1080/08941939.2018.1556364.
5. Aghdassi SJ, Schröder C, Gastmeier P. Gender-related risk factors for surgical site infections. Results from 10 years of surveillance in Germany. Antimicrobial Resistance & Infection Control. 2019; 8(1). doi:10.1186/s13756-019-0547-x
6. Chidi Ekpemo S. The use of prophylactic antibiotics in day case herniotomy at Abia State University teaching hospital, Aba, Nigeria. Advances in Surgical Sciences. 2018; 6(1):36. doi:10.11648/j.ass.20180601.17.
7. Zhiqing L, Yongyun C, Wenxiang C, Mengning Y, Yuanqing, M, Zhenan, Z et al. Surgical masks as source of bacterial contamination during operative procedures. Journal of Orthopaedic Translation. 2018;14(1)57-62. doi:10.1016/j.jot.2018.06.002.
8. Li X, Chen H, Zhu S, Liu Y, Yang, J, Yuan, Z et al. Efficacy and feasibility of a collaborative multidisciplinary program for antibiotic prophylaxis in clean wound surgery. International Journal of Clinical Pharmacy. 2017;40(1):150-159. doi:10.1007/s11096-017-0576-6.
9. Chatterjee, A., Modarai, M., Naylor, N. R., Boyd, S. E., Atun, R., Barlow, J., … Robotham JV. Quantifying drivers of antibiotic resistance in humans: A systematic review. The Lancet Infectious Diseases. 2018;18(12),e368-e378. doi:10.1016/s1473-3099(18)30296-2.
10. Kayani Z, Awan S, Abbasi M, Gilani I, Akram N, Sabir F. Role of prophylactic antibiotics in clean surgery. Pakistan Journal of Physiology. 2019;15(2):38-0.
11. Retrieved from https://www.cdc.gov/nhsn/pdfs/pscmanual/9pscssicurrent.pdf
12. Cheadle WG. Risk factors for surgical site infection. Surgical Infections. 2006;7(s1):s7-s11. doi:10.1089/sur.2006.7.s1-7.
13. Kaye K, Schmit K, Pieper C, Sloane R, Caughlan K, Sexton D et al. The effect of increasing age on the risk of surgical site infection. The Journal of Infectious Diseases. 2005;191(7):1056-1062. doi:10.1086/428626.
14. Koullouros M, Khan N, Aly EH. The role of oral antibiotics prophylaxis in prevention of surgical site infection in colorectal surgery. International Journal of Colorectal Disease. 2016;32(1):1-18. doi:10.1007/s00384-016-2662-y.
15. Vander P, V, Uyttebroek S, Robbins KT, Rodrigo JP, De Bree R et al. Perioperative antibiotics in clean-contaminated head and neck surgery: A systematic review and meta-analysis. Advances in Therapy. 2020;37(4):1360-1380. doi:10.1007/s12325-020-01269-2.
16. Syed MK, Al Faqeeh, AA, Othman A, Hussein AA, Rajab H, Hussain S et al. Antimicrobial prophylaxis in clean pediatric surgical procedures: A necessity or redundancy? Cureus. 2020; 12(9):e10701. doi:10.7759/cureus.10701.
17. Anand T, Gupta S, Gupta A. Routine use of antibiotics in hernia surgery in children: Is it really required? Journal of Medical Science And clinical Research. 2018;6(9). doi:10.18535/jmscr/v6i9.187.
18. Orelio CC, Van-Hessen C, Sanchez-Manuel FJ, Aufenacker TJ, Scholten RJ. Antibiotic prophylaxis for prevention of postoperative wound infection in adults undergoing open elective inguinal or femoral hernia repair. Cochrane Database of Systematic Reviews. 2020. 21;4(4):CD003769. doi:10.1002/14651858.cd003769.pub5.
Copyright (c) 2021 Nabi Bux Napar, Noor Ahmed Shaikh, Imamuddin Baloch, Azhar Ali Shah, Bushra Shaikh, Ishrat Mahtam
This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.
All research articles published in the Journal of Rawalpindi Medical College (JRMC) are fully open access: immediately freely available to read, download, and share. Copyrights of all articles published in JRMC are retained by the authors. First publication rights are granted to JRMC. The journal/publisher is not responsible for subsequent uses of the work.
All articles are published under the Creative Commons Attribution (CC BY-SA 4.0) license.