IntroductionThe aim was to produce a multidisciplinary consensus to determine the current position on the nomenclature, definition, diagnosis, imaging modalities and management of Sportsman's groin (SG).MethodsExperts in the diagnosis and management of SG were invited to participate in a consensus conference held by the British Hernia Society in Manchester, UK on 11–12 October 2012. Experts included a physiotherapist, a musculoskeletal radiologist and surgeons with a proven track record of expertise in this field. Presentations detailing scientific as well as outcome data from their own experiences were given. Records were made of the presentations with specific areas debated openly.ResultsThe term ‘inguinal disruption’ (ID) was agreed as the preferred nomenclature with the term ‘Sportsman's hernia’ or ‘groin’ rejected, as no true hernia exists. There was an overwhelming agreement of opinion that there was abnormal tension in the groin, particularly around the inguinal ligament attachment. Other common findings included the possibility of external oblique disruption with consequent small tears noted as well as some oedema of the tissues. A multidisciplinary approach with tailored physiotherapy as the initial treatment was recommended with any surgery involving releasing the tension in the inguinal canal by various techniques and reinforcing it with a mesh or suture repair. A national registry should be developed for all athletes undergoing surgery.ConclusionsID is a common condition where no true hernia exists. It should be managed through a multidisciplinary approach to ensure consistent standards and outcomes are achieved.

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This study sought to determine in a district general hospital (a) the frequency and nature of bacterial contamination at operation, (b) the incidence of consequent infection and (c) the prophylactic effect, if any, of interparietal povidone-iodine against postoperative wound infection. Bacterial contamination was shown in 49 per cent of all the abdominal surgical wounds at the end of operation. From 61 per cent of the subsequently infected wounds, organisms identified as contaminants at operation were again found. Interparietal instillation of povidone-iodine resulted in a statistically significant reduction in wound infection (P less than 0.01) in treated patients compared with untreated, randomized, matched controls. It was of significant value in cases of intestinal resection and peritonitis, in obese patients and in those with paramedian incisions. Laboratory studies indicate that povidone-iodine does not induce bacterial resistance. This chemical antibacterial agent may thus provide a preferable alternative to antibiotics in preventing such infections.

Povidone iodine is now being increasingly used in hospitals as an antiseptic. The possible habituation of bacteria to iodine was studied by serial passage of two strains of Pseudomonas aeruginosa, two strains of Escherichia coli, two strains of Klebsiella aerogenes, and one strain of Serratia marcescens in subinhibitory concentrations. After 20 passages, no significant change was observed in the minimal inhibitory concentration, minimal bactericidal concentration, and killing times between parent strains and 20th subcultures under standardized conditions.

A study at the Reading District Hospitals on 451 consecutive patients undergoing appendicectomy through grid‐iron incisions sought to determine factors influencing wound infection and the effects of a prophylactic wound‐spraying procedure. Wound infection increased with the severity of appendicular inflammation and was well correlated with the degree and nature of bacterial contamination at the time of wound closure1. The infection rate was reduced by about one‐half when either an aerosol dry‐powder formulation of povidone iodine (Disadine D. P.1) or an aerosol antibiotic powder spray containing neomycin, bacitracin and polymixin (Dispray) was sprayed on the wound before and after closure. The reduction of infection achieved by spraying with pouidine iodine was statistically significant (P<0.025). The results of the polyantibiotic spraying did not quite reach significance (P<0.06)1. The povidone iodine dry powder was better overall since it reduced infection in all degrees of appendicular inflammation, in all age groups and in enlarged, drained, contaminated and non‐contaminated wounds without the attendant disadvantages of antibiotics.