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Master of Public Health

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

AUTHORS

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 , . American journal of surgery. 2024 1 5; ().

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.

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