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

Am J Surg. 2024 Jun:232:68-74. doi: 10.1016/j.amjsurg.2024.01.004. Epub 2024 Jan 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.

Publication types

  • Randomized Controlled Trial
  • Multicenter Study

MeSH terms

  • Adult
  • Aged
  • Anti-Bacterial Agents* / administration & dosage
  • Anti-Bacterial Agents* / therapeutic use
  • Clindamycin / administration & dosage
  • Clindamycin / therapeutic use
  • Female
  • Gentamicins* / administration & dosage
  • Gentamicins* / therapeutic use
  • Hernia, Ventral* / surgery
  • Herniorrhaphy* / adverse effects
  • Humans
  • Incidence
  • Male
  • Middle Aged
  • Prospective Studies
  • Surgical Mesh
  • Surgical Wound Infection* / epidemiology
  • Surgical Wound Infection* / prevention & control
  • Therapeutic Irrigation* / methods
  • Treatment Outcome

Substances

  • Anti-Bacterial Agents
  • Gentamicins
  • Clindamycin