Impact of Surgical Site Infections on Elective Incisional Hernia Surgery: A Prospective Study

Juvany, Montserrat; Hoyuela, Carlos; Trias, M; Carvajal, Fernando; Ardid, Jordi; Martrat, Antoni

doi:10.1089/sur.2017.233

Cited by 19 publications

(10 citation statements)

References 23 publications

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“…The study has also incorporated a PROM in the form of Bluebelle and provided insights that will support its use in future studies. Clinicians and policy makers should ensure they have accurate data on SSI incidence and outcomes in their ASH practice, especially as this has implications on recurrence 23 . This monitoring could be supported by integration of Bluebelle into routine clinical care.…”

Section: Discussionmentioning

confidence: 99%

Surgical site infections after emergency hernia repair: substudy from the Management of Acutely Symptomatic Hernia (MASH) study

et al. 2023

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Introduction Acutely symptomatic abdominal wall and groin hernias (ASH) are a common acute surgical presentation. There are limited data to guide decisions related to surgical repair technique and use of antibiotics, which can be driven by increased risk of surgical site infection (SSI) in this group. This study aims to report rates of SSI following ASH repair and explore the use of patient-reported outcome measure reporting in this setting. Methods An 18-week, UK-based, multicentre prospective cohort study (NCT04197271) recruited adults with ASH. This study reports operatively managed patients. Data on patient characteristics, inpatient management, quality of life, complications, and wound healing (Bluebelle score) were collected. Descriptive analyses were performed to estimate event rates of SSI and regression analysis explored the relationship between Bluebelle scores and SSI. The 30 and 90-day follow-up visits assessed complications and quality of life. Results The MASH study recruited 273 patients, of whom 218 were eligible for this study, 87.2 per cent who underwent open repair. Mesh was used in 123 patients (50.8 per cent). Pre- and postoperative antibiotics were given in 163 (67.4 per cent) and 28 (11.5 per cent) patients respectively. There were 26 reported SSIs (11.9 per cent). Increased BMI, incisional, femoral, and umbilical hernia were associated with higher rates of SSI (P = 0.006). In 238 patients, there was a difference in healthy utility values at 90 days between patients with and without SSI (P = 0.025). Also, when analysing 191 patients with Bluebelle scores, those who developed an SSI had higher Bluebelle values (P < 0.001). Conclusion SSI is frequent in repair of acutely symptomatic hernia and correlates with BMI and site of hernia.

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Section: Discussionmentioning

confidence: 99%

Surgical site infections after emergency hernia repair: substudy from the Management of Acutely Symptomatic Hernia (MASH) study

et al. 2023

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“…5,6 Although we found in a heterogeneous series that included many types of surgical procedures (onlay and sublay) and hernia sites (midline, paramedial) that SSI was related to 1-year recurrence, those findings did not occur in this cohort. 17 Based on a literature review on open retromuscular repair (Rives 4 and Rives-Stoppa 18 techniques), we can appreciate that most of the series are retrospective and recurrence rates vary from 1.1% to 32% 2,19-23 (Table 2). SSOs on these studies are less common than in our cohort, probably because of the retrospective design of the studies.…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Results of a Prospective Cohort Study on Open Rives Technique of the Midline Incisional Hernia: Midline Closure and Mesh Overlap

et al. 2021

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Background. Rives repair has been traditionally used for large abdominal wall defects with good results on terms of recurrence. However, it is limited by the lateral border of the posterior rectus sheath. The objective of our study was to evaluate recurrence rate, midline closure and mesh overlap in patients operated on elective midline incisional hernia by open Rives retromuscular repair. Methods. This is a prospective observational study of 83 patients who underwent elective open Rives technique between January 2014 and December 2018. Main inclusion criteria were adults with a midline incisional hernia. Recurrence, midline closure and mesh overlap were determined. Results. At a median postoperative follow-up of 32 (5-59) months, 8 cases of recurrence were reported. Patients with recurrence had wider hernia defects (101 ± 52 mm vs 66 ± 36 mm, P = .014) and were repaired with wider meshes (191 ± 93 mm vs 137 ± 68 mm, P = .042). However, although it was not statistically significant, midline closure was lower (38% vs 59%), as well as the overlapping relationship between mesh area and hernia defect area (2.937:1 vs 3.732:1) on patients that developed a recurrence. Conclusions. Rives technique provides good mid-term results in a midline incisional hernia (10% of recurrence at 36 months), including wider hernias in the recurrent cohort. The authors believe that other techniques which allow midline closure and placement of bigger meshes should be considered, especially in those hernias classified as W3 on EuraHS classification (more than 10 cm on width size).

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“…Although incisional hernia repair is classified as a clean surgery, it still has a high incidence of surgical site infection (SSI) (0.7%-26.6%). The presence of an SSI could increase early recurrence rates after hernia repair (18).…”

Section: Discussionmentioning

confidence: 99%

Early and Late Outcome After Suprasonic Excision of Infected Mesh Implants After Hernioplasty

Пантелеев

Заварухин²,

Pogorelova³

et al. 2019

Serbian Journal of Experimental and Clinical Research

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Th e purpose of this research is to analyze early and postponed complications of the new method to eliminate mesh implants during full-grown infection process.Th e Republican clinical hospital (Russia) was the location to carry out a post-hoc analysis of 149 cases on surgical removal of infected mesh implants for ventral hernias of different localization in the period 2000 to 2017. Th e control group were 78 patients who underwent meshes removal with traditional surgical instruments. Th e study group included 71 patients, who underwent our method of supra-sonic excision of the implants.Th e duration of surgery in the group of patients subjected to supra-sonic excision of the implants was signifi cantly lower (84.3 min vs. 141.5 min) than in the group of traditional surgical techniques. Complications of early postoperative period was most often registered in the control group: foreign bodies (92.8% vs. 7.2%), infection (81.8% vs. 18.2%) and bleeding (87.5% vs. 12.5%). In the long term the recurrence of hernias in the control group were detected 1.8 times more frequently for ventral hernias than in the group of supra-sonic excision of the implants.Th us, supra-sonic excision of the implant prevents damage to viable tissues of the abdominal wall during the allocation of the implant and provides a good bactericidal eff ect, which promotes normal tissue regeneration and prevents possible recurrence of the herniation. Keywords: hernias, suprasonic excision of infected mesh, early and late outcome SAŽETAKCilj ovog istraživanja je analiza ranih i odloženih komplikacija novog metoda za eliminaciju mrežnih impantata tokom celokupnog procesa infekcije.Republička klinička bolnica (Rusija) je predstavljala lokaciju sprovođenje post-hoc analize 149 slučajeva hirurškog uklanjanja infi ciranih mrežnih impantata ventralnih kila različite lokalizacije u periodu od 2000. do 2017. Kontrolnu grupu je činilo 78 pacijenata kod kojih je mrežica uklonjena tradicionalnim hirurškim instrumenti. Eksperimentalna grupa se sastojala od 71 pacijenta koji su bili podvrgnuti našem metodu suprazvučne ekscizije impantata.Trajanje hirurške intervencije u grupi pacijenata podvrgnutih suprazvučnoj eksciziji implantata značajno je bila niža (84,3 min naspram 141,5 min) nego u grupi u kojoj su korišćene tradicionalne hirurške tehnike. Komplikacije ranog postoperativnog perioda su najčešć e registrovane u kontrolnoj grupi: strana tela (92,8% naspram 7,2%), infekcija (81,8% naspram 18,2%) i krvarenje (87,5% naspram 12,5%). U pogledu kasnih ishoda ponovna pojava kila u kontrolnoj grupi je zabeležena 1.8 puta češć e nego u grupi sa suprazvučnom ekscizijom implantata.Prema tome, suprazvučna ekscizija implantata prevenira ošteć enja tkiva abdominalnog zida prilikom ugradnje implantata i pruža dobar baktericidni efekat, što stimuliše normalnu regeneraciju tkiva i sprečava moguć unost ponovne pojave kila.Ključne reči: kila, suprazvučna ekscizija infi cirane mreže, rani i kasni ishodi

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Impact of Surgical Site Infections on Elective Incisional Hernia Surgery: A Prospective Study

Abstract: Surgical site infection rates are high for incisional hernia surgery (16%), and associated with local complications. Surgical site infection requires long-term treatments and leads to a higher one-year recurrence rate.

Cited by 19 publications

References 23 publications

Surgical site infections after emergency hernia repair: substudy from the Management of Acutely Symptomatic Hernia (MASH) study

Surgical site infections after emergency hernia repair: substudy from the Management of Acutely Symptomatic Hernia (MASH) study

Results of a Prospective Cohort Study on Open Rives Technique of the Midline Incisional Hernia: Midline Closure and Mesh Overlap

Early and Late Outcome After Suprasonic Excision of Infected Mesh Implants After Hernioplasty

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