820 “Antibiotics Because We’re Inserting a Mesh”: A Study to Evaluate Antibiotic Prophylaxis in Elective Hernia Repairs

Abstract

Abstract Aim Inguinal hernias are one of the most common pathologies worldwide. Over 20 million inguinal hernia repairs are performed each year. The HerniaSurge Collaboration recently updated their international guidelines for groin hernia management. They concluded that antibiotic prophylaxis is not recommended in elective open inguinal mesh hernia repairs in average-risk patients in a low infection risk environment. In laparoscopic hernia repairs, antibiotics are never recommended. This study aimed to identify current practice for antibiotic prophylaxis use in elective inguinal hernia repairs within our district general hospital environment. Method A retrospective study was performed, evaluating all elective inguinal hernia repairs with mesh between 1st June 2022-31st December 2022. Both laparoscopic and open techniques were included in this study. Operative notes were reviewed to ascertain if patients had been given antibiotics intra-operatively. Results The study identified 84 patients who underwent an inguinal hernia repair with mesh across a 7 month- period. Of these, all were operated on in a low-risk environment. 94% (N=79) were given antibiotic prophylaxis intraoperatively. Conclusions Antibiotic prophylaxis is still being used for low-risk patients undergoing elective inguinal hernia surgery. This is not in keeping with current hernia guidelines which suggests that there is no significant benefit to antibiotic use. Excessive antibiotic use is associated with an increase in adverse events, an increased rate of antibiotic resistant organisms and increased healthcare costs.