Surgical site infection: the “Achilles Heel” of all types of abdominal wall hernia reconstruction

Tubre, Dustin John; Schroeder, Alexander D.; Estes, Jacob M.; Eisenga, J.; Fitzgibbons, Robert J.

doi:10.1007/s10029-018-1826-9

Cited by 52 publications

(28 citation statements)

References 63 publications

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“…The occurrence of a clinically relevant infection depends on both patient-related factors as well as the quantity of bacteria. 26 An earlier conducted study by Tubre et al showed that contamination with more than 10 5 CFU per gram may result in wound infections. 26 Pathogens found in humans at surgical site infection were S. aureus and Enterococcus species.…”

Section: Discussionmentioning

confidence: 98%

Zinc-Impregnated Mesh for Abdominal Wall Repair Reduces Infection in a Rat Model of Peritonitis

Yurtkap

Jairam

Kaufmann

et al. 2020

Journal of Surgical Research

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Background: The objective of this study was to assess whether a zinc-impregnated polypropylene mesh (ZnMesh) has better antibacterial properties in a contaminated environment compared with a regular polypropylene mesh.Materials and methods: Thirty-eight Wistar Han rats underwent cecal ligation and puncture to induce peritonitis 24 h before implantation of an intraperitoneal ZnMesh or a regular polypropylene mesh. Primary outcome was the number of colony forming units (CFU) per sample (mesh and abdominal wall). Secondary outcomes were macroscopic (incorporation of mesh, abscesses, and adhesions on mesh surface) and histological (inflammatory cell reaction, mesh-specific parameters, and collagen deposition) parameters. All outcomes were evaluated after 30 and 90 d.Results: After 30 d, no significant difference in CFU per sample was present between the ZnMesh and control groups. After 90 d, a lower number of CFU per sample was present in the ZnMesh group compared with the control group (trypticase soy agar with 5% sheep blood: 0 log 10 CFU/sample IQR: 0-1.40 versus 1.58 log 10 CFU/sample IQR: 0-4.30, P ¼ 0.012; MacConkey: 0 log 10 CFU/sample IQR: 0-2.65 versus 1.18 log 10 CFU/sample IQR: 0-4.04, P ¼ 0.438). After 90 d, the percentage of adhesions on mesh surface was significantly higher in the ZnMesh group (95% IQR: 60%-100% versus 50% IQR: 23%-75%, P ¼ 0.029). No differences were seen in other macroscopic outcomes or histology.

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Section: Discussionmentioning

confidence: 98%

Zinc-Impregnated Mesh for Abdominal Wall Repair Reduces Infection in a Rat Model of Peritonitis

Yurtkap

Jairam

Kaufmann

et al. 2020

Journal of Surgical Research

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“…Surgical site infections and seromas are the Achilles heel of all types of abdominal wall hernia reconstruction (29). As in the onlay technique, high rates of surgical site infections and seromas are also seen in the Chevrel technique.…”

Section: Discussionmentioning

confidence: 99%

What Do We Know About the Chevrel Technique in Ventral Incisional Hernia Repair?

Köckerling

2019

Front. Surg.

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Introduction: In publications on ventral incisional hernia repair, the Chevrel technique and the onlay operation are often equated. This present review now aims to present the difference between these surgical techniques and analyze the findings available on the Chevrel technique. Materials and Methods: A systematic search of the available literature was performed in January 2019 using Medline, PubMed, Scopus, Embase, Springer Link, and the Cochrane Library, as well as a search of relevant journals, books, and reference lists. Thirty-four publications were identified as relevant for this review. For assessment of the Chevrel-technique with other surgical procedures there are no randomized controlled trials, prospective or retrospective comparative studies available but only case series. In the majority of case series the follow-up procedure is not reported. Results: In the onlay technique the defect is closed with direct suture or it is omitted altogether. Whereas, in the Chevrel technique this is done with sliding myofascial flaps harvested from the rectus sheaths. In the few case series available this appears to result in a lower recurrence rate for the Chevrel technique compared with the onlay technique. However, the rates of postoperative complications, surgical site occurrences (SSOs), surgical site infections (SSIs), seroma, and skin necrosis are as high as in the onlay technique. The reason for this is that both techniques require subcutaneous undermining with severance of perforator vessels. Conclusion: If mesh placement in onlay position has been chosen for specific reasons, preference can be given to the Chevrel technique over the standard onlay technique, although the study quality is limited.

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“…As diretrizes do CDC e NICE salientam a manutenção da temperatura do corpo como uma importante recomendação, apesar de não especificarem os métodos que poderiam ser utilizados para manter uma temperatura ideal (6)(7) . Estudos, em contrapartida, sugerem que o método menos eficaz para manter os pacientes aquecidos seria o uso de mantas de aquecimento, e que o ar forçado e os aparelhos para aquecimento de fluidos intravenosos seriam os mais eficazes (3,(14)(15) .…”

Section: Discussionunclassified

“…O centro cirúrgico é um setor complexo onde procedimentos anestésicos potencialmente invasivos são realizados, um dos principais determinantes para a ocorrência de infecções relacionadas à assistência à saúde (IRAS), principalmente as infecções de ferida cirúrgica (IFC) (1)(2) . Nos Estados Unidos e Europa, as IFC ocupam o segundo lugar no ranking de infecções relacionadas à saúde, com taxa de mortalidade de aproximadamente 0,4% a 0,8% e 5% a 10% em cirurgias mais complexas (3)(4) .…”

Section: Introdução Métodounclassified

Surgical Site Infection: Are Surveillance and Risk Prevention Measures Institutionally Applied?

Batista

Silva²,

Martins

et al. 2019

Cogitare Enferm.

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Objetivo: o objetivo deste estudo foi avaliar as medidas de vigilância e prevenção de infecções deferidas cirúrgicas em um hospital filantrópico no interior de Minas Gerais.Método: estudo quase-experimental realizado nas fases pré-intervenção, intervenção e pósintervenção.O teste qui-quadrado de Pearson foi utilizado quando o valor esperado era >5 e oteste exato de Fisher para o valore previsto <5. A correção de Bonferroni foi aplicada para múltiplascomparações (p<0,01).Resultados: a tricotomia com lâmina para remoção foi realizada por 66% dos profissionais. Atemperatura do paciente foi significativa (p=0,03) quando associada à categoria profissional.84% dos cirurgiões realizaram profilaxia antimicrobiana antes da incisão cirúrgica. Na fase pósintervenção,houve redução de 84,6% dos profissionais que preparavam a pele antes da incisãocirúrgica.Conclusão: o estudo gerou indicadores de qualidade para o centro cirúrgico e, na ausência deprotocolos de acompanhamento, subestimou eventos adversos provenientes da cirurgia.

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Surgical site infection: the “Achilles Heel” of all types of abdominal wall hernia reconstruction

Cited by 52 publications

References 63 publications

Zinc-Impregnated Mesh for Abdominal Wall Repair Reduces Infection in a Rat Model of Peritonitis

Zinc-Impregnated Mesh for Abdominal Wall Repair Reduces Infection in a Rat Model of Peritonitis

What Do We Know About the Chevrel Technique in Ventral Incisional Hernia Repair?

Surgical Site Infection: Are Surveillance and Risk Prevention Measures Institutionally Applied?

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