Reducing the incidence of surgical site infection after ventral hernia repair: Outcomes from the RINSE randomized
Jeremy A Warren1, Claiborne Lucas2, Lucas R Beffa3
1University of South Carolina School of Medicine Greenville and Prisma Health Upstate Department of Surgery, Greenville, SC, USA.
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.
