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

Warren, Jeremy A; Lucas, Claiborne; Beffa, Lucas R; Petro, Clayton C; Prabhu, Ajita S; Krpata, David M; Rosen, Michael J; Orenstein, Sean B; Nikolian, Vahagn C; Pauli, Eric M; Horne, Charlotte M; LaBelle, Molly; Phillips, Sharon; Poulose, Benjamin K; Carbonell, Alfredo M

Warren, Jeremy A; Lucas, Claiborne; Beffa, Lucas R; Petro, Clayton C; Prabhu, Ajita S; Krpata, David M; Rosen, Michael J; Orenstein, Sean B; Nikolian, Vahagn C; Pauli, Eric M; Horne, Charlotte M; LaBelle, Molly; Phillips, Sharon; Poulose, Benjamin K; Carbonell, Alfredo M.

Affiliation

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.

Am J Surg ; 232: 68-74, 2024 Jun.

Article in En | MEDLINE | ID: mdl-38199871

ABSTRACT

ABSTRACT

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 â+ âclindamycin (G â+ âC) (n â= â125) vs saline (n â= â125) 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 â%; p â= â0.836). No differences were seen in secondary

outcomes:

SSO (11.71 vs 13.64 â%; p â= â0.667); 90-day SSO (11.1 vs 13.9 â%; p â= â0.603); 90-day SSI (6.9 vs 3.8 â%; p â= â0.389); SSIPI (7.21 vs 7.27 â%, p â= â0.985); SSOPI (3.6 vs 3.64 â%; p â= â0.990); 30-day readmission (9.91 vs 6.36 â%; p â= â0.335); reoperation (5.41 vs 0.91 â%; p â= â0.056).

CONCLUSION:

Dual antibiotic irrigation with G â+ âC did not reduce the risk of surgical site infection during open retromuscular ventral hernia repair.

Subject(s)

Anti-Bacterial Agents; Gentamicins; Hernia, Ventral; Herniorrhaphy; Surgical Wound Infection; Therapeutic Irrigation; Humans; Hernia, Ventral/surgery; Surgical Wound Infection/prevention & control; Surgical Wound Infection/epidemiology; Male; Female; Middle Aged; Prospective Studies; Herniorrhaphy/adverse effects; Anti-Bacterial Agents/therapeutic use; Anti-Bacterial Agents/administration & dosage; Gentamicins/administration & dosage; Gentamicins/therapeutic use; Incidence; Therapeutic Irrigation/methods; Clindamycin/therapeutic use; Clindamycin/administration & dosage; Aged; Surgical Mesh; Treatment Outcome; Adult

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Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Surgical Wound Infection / Gentamicins / Herniorrhaphy / Hernia, Ventral / Therapeutic Irrigation / Anti-Bacterial Agents Type of study: Clinical_trials / Incidence_studies / Risk_factors_studies Limits: Adult / Aged / Female / Humans / Male / Middle aged Language: En Journal: Am J Surg Year: 2024 Document type: Article Country of publication: United States

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