Low Incidence of Surgical Site Infection in Laparoscopic Inguinal Herniorrhaphy

Maris S Jones, MD, Charles St Hill, MD, Shawn Tsuda, MD. University of Nevada School of Medicine

Introduction:

The objective of this study is to evaluate the incidence of surgical site infection in laparoscopic (TEP) versus open inguinal hernia repair. Data is equivocal for antibiotic prophylaxis in open inguinal hernia repair for a reduction of surgical site infections. There is a paucity of data regarding surgical site infection in laparoscopic inguinal hernia repair. The primary outcome of this study is the incidence of surgical site infections in inguinal herniorrhaphy (laparoscopic versus open) leading to mesh infection. All patients received single-dose prophylactic antibiotics in an academic medical center. The secondary outcome under investigation is the incidence of surgical site infection.

Methods and Procedures:

A single institution, retrospective chart review was performed on 222 adult patients who underwent consecutive elective inguinal herniorrhaphy from 2008-2011. Surgical site infections were recorded in each group utilizing the definition from the Centers for Disease Control. Mesh infection was defined as any surgical site infection that led to mesh removal. Both mesh and surgical site infections were included in the data set if they occurred within 90 days of surgery. Both groups received single-dose antibiotic prophylaxis. Fisher exact and student’s t-test were utilized to analyze the results, with statistical significance of p < 0.05.

Results:

A total of 222 patients were evaluated. The rate of surgical site infections that lead to mesh infection in laparoscopic inguinal hernia repairs was 0% (0/97). The rate of surgical site infection that lead to mesh infection in open inguinal hernia repairs was also 0% (0/125); p=1.00. The surgical site infection rate for the laparoscopic inguinal hernia repair group was 1.0% (1/97) compared to a 4.8%(6/125) infection rate in the open inguinal herniorrhapy group (p=0.05).

Conclusion:

The rate of surgical site infection after laparoscopic inguinal herniorrhaphy is lower than that for open inguinal herniorrhaphy in this series. No infections lead to mesh removal. Routine antibiotic prophylaxis for prevention of surgical site infection may not be necessary for laparoscopic inguinal herniorraphy given the low incidence of mesh or surgical site infection.

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