Reducing the incidence of surgical site infection after ventral hernia repair: Outcomes from the RINSE randomized control trial.

Autor: Warren JA; University of South Carolina School of Medicine Greenville and Prisma Health Upstate Department of Surgery, Greenville, SC, USA. Electronic address: Jeremy.warren@prismahealth.org., Lucas C; Prisma Health Upstate Department of Surgery, Greenville, SC, USA., Beffa LR; The Cleveland Clinic Foundation, Cleveland, OH, USA., Petro CC; The Cleveland Clinic Foundation, Cleveland, OH, USA., Prabhu AS; The Cleveland Clinic Foundation, Cleveland, OH, USA., Krpata DM; The Cleveland Clinic Foundation, Cleveland, OH, USA., Rosen MJ; The Cleveland Clinic Foundation, Cleveland, OH, USA., Orenstein SB; Oregon Health & Science University, Portland, OR, USA., Nikolian VC; Oregon Health & Science University, Portland, OR, USA., Pauli EM; Penn State Health Milton S Hershey Medical Center Department of Surgery, Hershey, PA, USA., Horne CM; Penn State Health Milton S Hershey Medical Center Department of Surgery, Hershey, PA, USA., LaBelle M; Department of Population Health Sciences, Weill Cornell Medicine, New York, NY, USA., Phillips S; Vanderbilt University Medical Center, USA., Poulose BK; The Ohio State University Wexner Department of Surgery and Center for Abdominal Core Health, Columbus, OH, USA., Carbonell AM; University of South Carolina School of Medicine Greenville and Prisma Health Upstate Department of Surgery, Greenville, SC, USA.
Jazyk: angličtina
Zdroj: American journal of surgery [Am J Surg] 2024 Jun; Vol. 232, pp. 68-74. Date of Electronic Publication: 2024 Jan 05.
DOI: 10.1016/j.amjsurg.2024.01.004
Abstrakt: Background: The clinical and financial impact of surgical site infection after ventral hernia repair is significant. Here we investigate the impact of dual antibiotic irrigation on SSI after VHR.
Methods: This was a multicenter, prospective randomized control trial of open retromuscular VHR with mesh. Patients were randomized to gentamicin ​+ ​clindamycin (G ​+ ​C) (n ​= ​125) vs saline (n ​= ​125) irrigation at time of mesh placement. Primary outcome was 30-day SSI.
Results: No significant difference was seen in SSI between control and antibiotic irrigation (9.91 vs 9.09 ​%; p ​= ​0.836). No differences were seen in secondary outcomes: SSO (11.71 vs 13.64 ​%; p ​= ​0.667); 90-day SSO (11.1 vs 13.9 ​%; p ​= ​0.603); 90-day SSI (6.9 vs 3.8 ​%; p ​= ​0.389); SSIPI (7.21 vs 7.27 ​%, p ​= ​0.985); SSOPI (3.6 vs 3.64 ​%; p ​= ​0.990); 30-day readmission (9.91 vs 6.36 ​%; p ​= ​0.335); reoperation (5.41 vs 0.91 ​%; p ​= ​0.056).
Conclusion: Dual antibiotic irrigation with G ​+ ​C did not reduce the risk of surgical site infection during open retromuscular ventral hernia repair.
Competing Interests: Declaration of competing interest The following authors have outside financial interests: Intuitive (Warren, Beffa, Prabhu, Nikolian, Pauli, Carbonell), Johnson and Johnson/Ethicon (Warren), Surgimatrix (Petro, Prabhu), Bard-Davol (Petro, Horne, Poulose), Advanced Medical Solutions Group (Petro, Poulose), CMR Surgical (Prabhu), Abdominal Core Health Quality Collaborative (Rosen, Poulose), Ariste Medical (Rosen), Medtronic (Nikolian, Pauli, Carbonell), Caresyntax (Nikolian), Beckton-Dickson (Pauli), Boston Scientific (Pauli), Actuated Medical (Pauli), Cook Biotech (Pauli), Neptune Medical (Pauli), Noah Medical (Pauli), Allergan (Pauli), ERBE (Pauli), Integra (Pauli), Steris (Pauli), Vicarious (Pauli), UpToDate (Pauli), Springer (Pauli), Deep Blue Medical Advances (Carbonell). The authors used no AI or AI assisted technologies in the writing process. This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.
(Copyright © 2024 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
Externí odkaz: