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Randomized Controlled Trial
. 2024 Jun:232:68-74.
doi: 10.1016/j.amjsurg.2024.01.004. Epub 2024 Jan 5.

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

Jeremy A Warren  1 , Claiborne Lucas  2 , Lucas R Beffa  3 , Clayton C Petro  3 , Ajita S Prabhu  3 , David M Krpata  3 , Michael J Rosen  3 , Sean B Orenstein  4 , Vahagn C Nikolian  4 , Eric M Pauli  5 , Charlotte M Horne  5 , Molly LaBelle  6 , Sharon Phillips  7 , Benjamin K Poulose  8 , Alfredo M Carbonell  9
Affiliations
Randomized Controlled Trial

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

Jeremy A Warren et al. Am J Surg. 2024 Jun.

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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Conflict of interest statement

Declaration of competing interest The following authors have outside financial interests: Intuitive (Warren, Beffa, Prabhu, Nikolian, Pauli, Carbonell), Johnson and Johnson/Ethicon (Warren), Surgimatrix (Petro, Prabhu), Bard-Davol (Petro, Horne, Poulose), Advanced Medical Solutions Group (Petro, Poulose), CMR Surgical (Prabhu), Abdominal Core Health Quality Collaborative (Rosen, Poulose), Ariste Medical (Rosen), Medtronic (Nikolian, Pauli, Carbonell), Caresyntax (Nikolian), Beckton-Dickson (Pauli), Boston Scientific (Pauli), Actuated Medical (Pauli), Cook Biotech (Pauli), Neptune Medical (Pauli), Noah Medical (Pauli), Allergan (Pauli), ERBE (Pauli), Integra (Pauli), Steris (Pauli), Vicarious (Pauli), UpToDate (Pauli), Springer (Pauli), Deep Blue Medical Advances (Carbonell). The authors used no AI or AI assisted technologies in the writing process. This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

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