Title: Efficiency of Local Antiseptic solution on the Incidence of Surgical Site Infection after Inguinal Hernia repair – A Prospective Study in a Tertiary Rural Hospital
Authors: Shashirekha CA, Karthik Hareen TVK, Ravikiran HR, Sukanya M
DOI: https://dx.doi.org/10.18535/jmscr/v5i7.140
Abstract
Introduction: The risk of wound infection after inguinal hernia repair depends on several factors. One of the most important factors is the preoperative skin preparation. The use of antisepsis is performed to reduce the risk of surgical site infections (SSIs) and to remove causing organisms. This work compares two different agent forms for preoperative skin preparation to prevent Surgical site infections (SSIs)
Materials and Methods: 100 adult patients were divided and randomized into two groups, each containing 50 patients. Both groups included patients that are scheduled for elective Lichtenstein inguinal hernia repair. The first group includes patients whose skin preparations were done with povidone iodine (PI) only. The second group included patients that are treated with two antiseptics; Alkosol (96% ethanol, isopropanol-30g and ortophenilphenol- 0.1g) and povidone iodide. The povidone iodide is applied after Alkosol has evaporated. The presence of bacterial growth in the wound was determined 24 and 48 hours after operation. Swabs were used to take samples, which were then cultivated to check for bacterial growth. The presence of infection was also determined by the following criteria: pain or tenderness, induration, erythema, local warmth of the wound etc
Results: The surgeon or clinician declared that after 24 hours the wound was infected in 20 patients in the control group and in 22 patients after 48 hours. In the Alkosol (96% ethanol, isopropanol-30g and ortophenilphenol0.1g) andpovidone iodide group infection was declared in only 3 patients after 24 hours.
Discussion: Compared to the use of providone only, the use of Alkosol (96% ethanol, isopropanol-30g and ortophenilphenol-0.1g) and povidone iodide has many advantages and was associated with lower rates of SSIs following clean surgery. A larger trial is warranted in order to add definitive and more conclusive data to the current evidence base.
Keywords: surgical site infection; ethanol; povidone iodide; hernia repair.
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Karthik Hareen TVK
Post graduate, Dept of General Surgery,
Sri Devraj Urs Medical College, Kolar