DO TOPICAL ANTIBIOTICS PROVIDE IMPROVED PROPHYLAXIS AGAINST BACTERIAL-GROWTH IN THE PRESENCE OF POLYPROPYLENE MESH

BACKGROUND: Herniorrhaphies using a foreign body such as mesh can beco me infected, An experiment was performed in rabbits to compare three m ethods of antibiotic treatment to prevent the growth of bacteria in me sh-containing wounds. METHODS: This experiment compared preoperative i ntravenous antibiotics (cefazolin), topical antibiotics applied intrao peratively (bacitracin), and their combination in preventing the quant itative growth of bacteria in a subcutaneous wound containing a polypr opylene mesh inoculated with Staphylococcus aureus, The bacteria were inoculated in doses sufficient to deliberately cause the growth of 130 .0 +/- 56.4 x 10(4) bacteria per gram of tissue in saline-treated cont rol animals. Quantitative cultures of the mesh and surrounding tissues were obtained 5 days after insertion of the mesh and inoculation of t he wound. RESULTS: Experimental data showed that treatment with system ic intravenous antibiotics, topical powdered antibiotics, or their com bination all statistically significantly decreased the quantitative cu ltures grown from the inoculated tissues as compared with saline-treat ed controls (P < 0.05). However, there were no statistically significa nt differences in quantitative growth among the three methods of antib iotic treatment, CONCLUSIONS: Antibiotics reduced the quantitative gro wth of bacteria in tissues excised from wounds inoculated with bacteri a. However, preoperative intravenous antibiotics, topical powdered ant ibiotics, and their combination all were equally effective.