amoxicillin-potassium-clavulanate-combination and Hernia--Ventral

To analyze the safety in combing laparoscopic ventral hernia repair with a mesh and bariatric surgery.. Obesity is one of the important precipitating factors for primary and recurrent ventral hernias (incisional and umbilical) and it is not uncommon to find these hernias in patients opting for obesity surgery. But, with no consensus or recommendation and concern of mesh infection, surgeons fear in combining these procedures, especially Roux en Y gastric bypass and sleeve gastrectomy.. In this study, we have retrospectively analyzed all patients who underwent concomitant bariatric procedure and mesh repair for ventral hernia at our institute.. A total of 36 out of 765 patients operated at our institute between 2003 and 2011 had concomitant procedures. Eleven patients had Roux en Y gastric bypass (group I) and remaining 25 had sleeve gastrectomy (group II) performed on them. The operating times were 149 min(120-210 min) in group I and 122 min (90-220min) in group II. No immediate complications or any incidence of mesh infection or recurrence in either of the groups.. Concomitant mesh repair for ventral hernias can be safely combined with bariatric procedures like Roux en Y gastric bypass and sleeve gastrectomy. But, for beginners, these should be done only in selected cases after fully informed consent from the patients.

Topics: Adult; Amoxicillin-Potassium Clavulanate Combination; Anti-Bacterial Agents; Female; Gastric Bypass; Gastroplasty; Hernia, Ventral; Humans; Laparoscopy; Length of Stay; Male; Middle Aged; Obesity, Morbid; Patient Selection; Retrospective Studies; Surgical Mesh; Treatment Outcome

Topics: Abdominal Abscess; Adenocarcinoma; Aged; Amoxicillin-Potassium Clavulanate Combination; Anti-Bacterial Agents; Colorectal Neoplasms; Eikenella corrodens; Female; Gram-Negative Bacterial Infections; Haemophilus Infections; Hernia, Ventral; Humans; Intestinal Obstruction; Intestine, Small; Intraoperative Complications; Ofloxacin; Streptococcal Infections; Surgical Wound Infection; Tissue Adhesions

Antibiotic prophylaxis in clean surgery with implantation of prosthetic material is widely accepted, although there are no studies on its use in abdominal incisional hernia repair. The objective was to evaluate antibiotic chemoprophylaxis in incisional herniorrhaphy with the implantation of prosthetic material. A prospective non-randomized study (1990-1998) was conducted to analyse 216 patients undergoing surgery for abdominal incisional hernia who required a prosthesis (polypropylene) in the reconstruction and who met the criteria for clean surgery. Risk factors were observed in 31.5%, the most frequent being diabetes and obesity. The incisional hernia was located mostly in the abdominal midline and in 64.4% measured over 10 cm. Antibiotic prophylaxis was administered in 140 patients (64.8%) via the systemic route, the antibiotics being first- or second-generation cephalosporins or amoxicillin-clavulanic acid. Surgical wound infection occurred in 39 patients (18.1%), 19 who had received antibiotic prophylaxis (13.6%) and 20 who had not (26.3%). In multivariate analysis using logistic regression, the variables with statistical significance for local septic infection were antibiotic prophylaxis and number of risk factors. We can conclude therefore that antibiotic chemoprophylaxis is useful in abdominal incisional herniorrhaphy surgery with implantation of prosthetic material for reducing local septic complications.

Topics: Aged; Amoxicillin-Potassium Clavulanate Combination; Antibiotic Prophylaxis; Drug Therapy, Combination; Female; Hernia, Ventral; Humans; Logistic Models; Male; Middle Aged; Multivariate Analysis; Prospective Studies; Prostheses and Implants; Risk Factors; Staphylococcal Infections; Streptococcal Infections; Surgical Mesh; Surgical Wound Infection