scholarly journals Opioid Use and Incidence of Surgical Site Infection after Repair of Ventral and Incisional Hernia - A Prospective Clinical Study in a Tertiary Care Hospital in Tirupati

2021 ◽  
Vol 8 (22) ◽  
pp. 1841-1845
Author(s):  
Srikanth Reddy Challapalli ◽  
Venkata Prakash Gandikota ◽  
Theja Peddavenkatagiri ◽  
Harsha Vardhan Reddy Gerigi
Keyword(s):  
Hernia Repair ◽  
Surgical Site Infection ◽  
Hospital Stay ◽  
Ventral Hernia ◽  
Postoperative Period ◽  
Ventral Hernia Repair ◽  
Care Hospital ◽  
Site Infection ◽  
Opioid Use ◽  
Opioid Users

BACKGROUND Preoperative opioid use is one of the predisposing factors for complications after most of the surgical procedures. This study intends to evaluate the effect of preoperative opiates on the outcomes following repair of ventral hernia. METHODS We conducted a prospective study of patients who underwent consecutive ventral hernia repair for over one year with institutional review board approval. Data were obtained regarding the usage of opioids during the preoperative period, intraoperative period, and postoperative period. Follow-up of the cases was done during the postoperative period. Data were obtained regarding the postoperative complications, duration of hospital stay, and the analyzed results. RESULTS A striking thirty percent of the total sixty patients have satisfied the criteria for the usage of opioids preoperatively. Preoperative history and operative details were found to be almost similar between the two categories of patients (no preoperative opioid use versus preoperative opioid use). The median hospital stay duration trended towards increased patients with opioid usage versus non-opioid users (P = 0.06). The bowel function's return to the normal was delayed in opioid users compared with non-opioid users (P = 0.018). The risk of superficial surgical site infection was increased among patients who used opioids preoperatively than the patients without preoperative opioid usage (55.5 % vs. 9.5 %; P < 0.001) and remained the same after multivariable logistic regression. CONCLUSIONS Among patients who underwent repair of ventral hernia, those with preoperative opioid usage experienced an increased risk of superficial surgical site infection than patients without preoperative opioid usage. KEYWORDS Opioid, Ventral Hernia Repair, Surgical Site Infection

scholarly journals Stratification of Surgical Site Infection by Operative Factors and Comparison of Infection Rates after Hernia Repair

2014 ◽  
Vol 36 (3) ◽  
pp. 329-335 ◽  
Author(s):  
Margaret A. Olsen ◽  
Katelin B. Nickel ◽  
Anna E. Wallace ◽  
Daniel Mines ◽  
Victoria J. Fraser ◽  
...  
Keyword(s):  
Hernia Repair ◽  
Surgical Site Infection ◽  
Ventral Hernia ◽  
Bowel Obstruction ◽  
Ventral Hernia Repair ◽  
International Classification Of Diseases ◽  
Site Infection ◽  
Anatomic Site ◽  
Incisional Ventral Hernia ◽  
Open Versus

ObjectiveTo investigate whether operative factors are associated with risk of surgical site infection (SSI) after hernia repair.DesignRetrospective cohort study.PatientsCommercially insured enrollees aged 6 months-64 years with International Classification of Diseases, Ninth Revision, Clinical Modification procedure or Current Procedural Terminology, fourth edition, codes for inguinal/femoral, umbilical, and incisional/ventral hernia repair procedures from January 1, 2004, through December 31, 2010.MethodsSSIs within 90 days after hernia repair were identified by diagnosis codes. The χ2 and Fisher exact tests were used to compare SSI incidence by operative factors.ResultsA total of 119,973 hernia repair procedures were analyzed. The incidence of SSI differed significantly by anatomic site, with rates of 0.45% (352/77,666) for inguinal/femoral, 1.16% (288/24,917) for umbilical, and 4.11% (715/17,390) for incisional/ventral hernia repair. Within anatomic sites, the incidence of SSI was significantly higher for open versus laparoscopic inguinal/femoral (0.48% [295/61,142] vs 0.34% [57/16,524], P=.020) and incisional/ventral (4.20% [701/16,699] vs 2.03% [14/691], P=.005) hernia repairs. The rate of SSI was higher following procedures with bowel obstruction/necrosis than procedures without obstruction/necrosis for open inguinal/femoral (0.89% [48/5,422] vs 0.44% [247/55,720], P<.001) and umbilical (1.57% [131/8,355] vs 0.95% [157/16,562], P<.001), but not incisional/ventral hernia repair (4.01% [224/5,585] vs 4.16% [491/11,805], P=.645).ConclusionsThe incidence of SSI was highest after open procedures, incisional/ventral repairs, and hernia repairs with bowel obstruction/necrosis. Stratification of hernia repair SSI rates by some operative factors may facilitate accurate comparison of SSI rates between facilities.Infect Control Hosp Epidemiol 2014;00(0): 1–7

Creation of a novel risk score for surgical site infection and occurrence after ventral hernia repair

Hernia ◽  
2016 ◽  
Vol 21 (2) ◽  
pp. 261-269 ◽  
Author(s):  
K. E. Poruk ◽  
C. W. Hicks ◽  
J. Trent Magruder ◽  
N. Rodriguez-Unda ◽  
K. K. Burce ◽  
...  
Keyword(s):  
Hernia Repair ◽  
Surgical Site Infection ◽  
Ventral Hernia ◽  
Risk Score ◽  
Ventral Hernia Repair ◽  
Site Infection

Antibiotic Irrigation of the Surgical Site Decreases Incidence of Surgical Site Infection after Open Ventral Hernia Repair

2018 ◽  
Vol 84 (7) ◽  
pp. 1146-1151
Author(s):  
Lily Knight Fatula ◽  
Allison Nelson ◽  
Hamza Abbad ◽  
J. Alex Ewing ◽  
Ben H. Hancock ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Hernia Repair ◽  
Surgical Site Infection ◽  
Ventral Hernia ◽  
Ventral Hernia Repair ◽  
Categorical Variables ◽  
Chronic Obstructive ◽  
Site Infection ◽  
Continuous Variables ◽  
Open Ventral Hernia Repair

Surgical site infections (SSI) are common complications after open ventral hernia repair (OVHR), potentially requiring further intervention. Antibiotic lavage before abdominal closure has been shown to lower the incidence in intra-abdominal and soft tissue SSI. A retrospective review of OVHR was performed with mesh at Greenville Health System Hernia Center between 2008 and 2017. Patients were divided into three groups, receiving no antibiotic irrigation (Grp 1, n = 260), gentamicin alone (Grp 2, n = 263), or gentamicin 1 clindamycin (G 1 C) irrigation (Grp 3, n = 299). Differences in categorical variables among the three groups were tested using chi-squared or Fischer's exact test (for n < 5). Analysis of continuous variables was performed using analysis of variance or Kruskal-Wallis test for differences in length of stay. Logistic regression was performed using all clinically relevant variables to determine the effects of irrigation on SSI. Incidence of surgical site occurrence was significantly lower after G 1 C irrigation (Grp 1, 28.1%; Grp 2, 35.4%; Grp 3, 19.7%; P < 0.001). Incidence of SSI was significantly lower after G 1 C irrigation, but not G alone (Grp 1, 16.5%; Grp 2, 15.2%; and Grp 3, 5.4%; P < 0.001). Multivariate logistic regression demonstrated significantly increased SSI with contaminated wounds (OR 2.96; 95% confidence interval (CI) 1.39–6.21), dirty wounds (OR 3.84; 95% CI 1.49–9.69), and chronic obstructive pulmonary disease (OR 3.70; 95% CI 2.16–6.38), as expected. Use of G 1 C was an independent predictor of decreased SSI (OR 0.33; 95% CI 0.16–0.67). Irrigation with a combined G 1 C antibiotic irrigation significantly reduces the incidence of surgical site infection after OVHR with mesh.

History of MRSA Infection Considerably Increases Risk of Surgical Site Infection in Ventral Hernia Repair

2014 ◽  
Vol 219 (3) ◽  
pp. S99 ◽  
Author(s):  
Jenny Ousley ◽  
Rebeccah B. Baucom ◽  
Michael D. Holzman ◽  
Jesse M. Ehrenfeld ◽  
Kenneth W. Sharp ◽  
...  
Keyword(s):  
Hernia Repair ◽  
Surgical Site Infection ◽  
Ventral Hernia ◽  
Ventral Hernia Repair ◽  
Site Infection ◽  
History Of ◽  
Mrsa Infection
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