Purpose; . Local anesthetics effect on wound healing is well known (1), with its antimicrobial or antiinflamatory effect (2,3). We compared the use of wound infiltration (LWI) versus caudal block (CB) on wound infection and healing after inguinal herniotomy in pediatrics.
Methods; 50 patients were assigned randomly to two groups. Group L: 25 patients received 1mg/kg bupivacaine 0.25% (diluted as 1ml bupivacaine + 1ml normal saline) by local infiltration in the wound before closure of the skin and subcutaneous.
Group C: 25 patients received caudal block with 1mg/kg bupivacaine 0.25%. We measured wound infection and healing (primary outcome) using Southampton scoring system and postoperative analgesia (secondary outcome) using FLACC scale.
Results; There was statistically significant decreased in pain score scale in group C compared to group L at 15min (P=0.035), 60min (P=0.007), 3 hours postoperatively (P=0.049). Analgesic requirement shows statistically significant increase in group L at 15min. & 60 min. postoperative (P=0.022). There was statistically significance as regard Southampton scoring system between the 2 studied groups with higher number of patients with higher scores in group L (P=0.008). Comparison between the two groups according to preoperative and postoperative white blood cells count shows statistically significant increase in group C at day 7 postoperative (P=0.015). Postoperative complication was not statistically significant (p=1.000)
Conclusions;  LWI is safe and satisfactory analgesia for surgery, and compared to CB it is not overwhelming. CB provides better and longer analgesia, however complications are more common. Wound healing found to be better with CB but it was clinically insignificant, as all patients healed normally. LWI did not cause wound infection in any of the patients included in the study and showed decrease in WBCs in group L in day 7 postoperative.

THE EFFECT OF LOCAL WOUND INFILTERATION VERSUS CAUDAL BLOCK ON WOUND INFECTION AND HEALING AFTER INGUINAL HERNIOTOMY IN PAEDIATRICS-A RANDOMIZED STUDY