Does Preoperative Bowel Preparation Reduce Surgical Site Infections During Elective Ventral Hernia Repair?

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• 作者：David M. Krpata ; MD^a ; ^{krpatad@ccf.org} ; Ivy N. Haskins ; MD^a ; Sharon Phillips ; MSPH^b ; Ajita S. Prabhu ; MD ; FACS^a ; Steven Rosenblatt ; MD ; FACS^a ; Benjamin K. Poulose ; MD ; FACS^c ; Michael J. Rosen ; MD ; FACS^a
• 关键词：AHSQC ; Americas Hernia Society Quality Collaborative ; BP ; bowel preparation ; MBP ; mechanical bowel preparation ; OAP ; oral antibiotic preparation ; SSI ; surgical site infection ; SSO ; surgical site occurrence ; SSOPI ; surgical site occurrence requiring procedural intervention ; VHR ; ventral hernia repair
• 刊名：Journal of the American College of Surgeons
• 出版年：2017
• 出版时间：February 2017
• 年：2017
• 卷：224
• 期：2
• 页码：204-211
• 全文大小：148 K
• 卷排序：224

文摘

To date, little is known about the benefits of preoperative bowel preparation in patients undergoing elective ventral hernia repair (VHR). The purpose of this study was to determine the effect of preoperative bowel preparation on 30-day wound events in patients undergoing elective VHR using the Americas Hernia Society Quality Collaborative (AHSQC).Study DesignAll patients undergoing elective VHR from January 2013 through January 2016 were identified within the AHSQC. Patients undergoing emergency VHR and those with a CDC wound class IV were excluded from our analysis. Patients were divided into 2 groups: Clean (CDC wound class I) and Contaminated (CDC wound classes II and III). The association of preoperative bowel preparation with 30-day wound events was investigated using logistic regression modeling.ResultsA total of 3,709 patients met inclusion criteria; 3,101 (83.6%) had CDC wound class I, and 608 (16.4%) had CDC wound classes II or III. Within the Clean group, patients who underwent preoperative bowel preparation were significantly more likely to experience a surgical site infection (SSI), surgical site occurrence (SSO), and surgical site occurrence requiring procedural intervention (SSOPI). Within the Contaminated group, patients who underwent preoperative bowel preparation were significantly more likely to experience an SSOPI.ConclusionsThe use of preoperative bowel preparation in patients undergoing elective VHR does not reduce the risk of 30-day wound events.