Postoperative Prophylactic Antibiotics Reduce Surgical Site Infection Rates after Ventral Hernia Repair: A Systematic Review

Abstract

SSIs after ventral hernia repair (VHR) represent a significant complication. The impact of postoperative prophylactic antibiotics on the SSI rates after VHRs is unclear. A systematic review of PubMed and Web of Science databases from inception through March 2016 investigating the effect of postoperative prophylactic antibiotics after VHRs was performed. Strict inclusion and exclusion criteria were implemented, and the methodological quality of the included studies was assessed. After systematic independent assessment of 216 citations, four studies, involving 344 patients, met the inclusion criteria. Among the included studies, 164 patients received >24 hours of postoperative prophylactic antibiotics, whereas 180 patients were controls. The overall incidence of SSI among patients receiving postoperative antibiotics was 14.6 per cent (95% confidence interval [CI], 9.9 to 20.9) which compares favorably with the control group: 35.5 per cent (95% CI, 28.9 to 42.7) (odds ratio: 0.3, 95% CI: 0.2 to 0.5, P < 0.01). Among patient's receiving postoperative antibiotics, the pooled average duration of postoperative antibiotic treatment was 6.2 ± 0.4 days. Based on the available evidence, the use of postoperative prophylactic antibiotics seems to be associated with lower SSI rates after VHRs. Future prospective randomized controlled trials should be conducted to further confirm the efficacy of this prophylactic intervention.

Review of the current antibiotic guidelines used in dermatologic surgery

“…Risk factors that may lead to increased susceptibility to infections include immunocompromised or immunosuppressed patients, diabetes types 1 and 2, autoimmune diseases, post‐organ transplants, receiving chemotherapy, bone marrow transplant recipients, chronic steroid users, obesity, tobacco exposure, alcohol use, history of radiation therapy, the elderly, HIV infection history, cardiac transplant history recipients with cardiac valvulopathy, congenital heart defects with prosthetic devices, infective endocarditis, prosthetic cardiac valves, cyanotic congenital heart defects with shunts less than 6 months after the procedure, malignancy including leukemia, malnourishment, and hemophilia 11,47,48 …”