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

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

doi:10.1016/j.amjsurg.2024.01.004

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

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

Surgery

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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 + 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.

Original language	English (US)
Journal	American journal of surgery
DOIs	https://doi.org/10.1016/j.amjsurg.2024.01.004
State	Accepted/In press - 2024

ASJC Scopus subject areas

Surgery

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Warren, J. A., Lucas, C., Beffa, L. R., Petro, C. C., Prabhu, A. S., Krpata, D. M., Rosen, M. J., Orenstein, S. B., Nikolian, V. C., Pauli, E. M., Horne, C. M., LaBelle, M., Phillips, S., Poulose, B. K., & Carbonell, A. M. (Accepted/In press). Reducing the incidence of surgical site infection after ventral hernia repair: Outcomes from the RINSE randomized control trial. American journal of surgery. https://doi.org/10.1016/j.amjsurg.2024.01.004

Warren, JA, Lucas, C, Beffa, LR, Petro, CC, Prabhu, AS, Krpata, DM, Rosen, MJ, Orenstein, SB , Nikolian, VC, Pauli, EM, Horne, CM, LaBelle, M, Phillips, S, Poulose, BK & Carbonell, AM 2024, 'Reducing the incidence of surgical site infection after ventral hernia repair: Outcomes from the RINSE randomized control trial', American journal of surgery. https://doi.org/10.1016/j.amjsurg.2024.01.004

@article{8a6d84775dd342bdb8b79ecd82391593,

title = "Reducing the incidence of surgical site infection after ventral hernia repair: Outcomes from the RINSE randomized control trial",

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 + 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.",

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

note = "Publisher Copyright: {\textcopyright} 2024 Elsevier Inc.",

year = "2024",

doi = "10.1016/j.amjsurg.2024.01.004",

language = "English (US)",

journal = "American journal of surgery",

issn = "0002-9610",

publisher = "Elsevier Inc.",

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TY - JOUR

T1 - Reducing the incidence of surgical site infection after ventral hernia repair

T2 - Outcomes from the RINSE randomized control trial

AU - Warren, Jeremy A.

AU - Lucas, Claiborne

AU - Beffa, Lucas R.

AU - Petro, Clayton C.

AU - Prabhu, Ajita S.

AU - Krpata, David M.

AU - Rosen, Michael J.

AU - Orenstein, Sean B.

AU - Nikolian, Vahagn C.

AU - Pauli, Eric M.

AU - Horne, Charlotte M.

AU - LaBelle, Molly

AU - Phillips, Sharon

AU - Poulose, Benjamin K.

AU - Carbonell, Alfredo M.

PY - 2024

Y1 - 2024

N2 - 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.

AB - 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.

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U2 - 10.1016/j.amjsurg.2024.01.004

DO - 10.1016/j.amjsurg.2024.01.004

M3 - Article

C2 - 38199871

AN - SCOPUS:85182358043

SN - 0002-9610

JO - American journal of surgery

JF - American journal of surgery

ER -

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

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