Abstract
Introduction
Postoperative wound events following ventral hernia repair are an important outcome measure. While efforts have been made by hernia surgeons to identify and address risk factors for postoperative wound events following VHR, the definition of these events lacks standardization. Therefore, the purpose of our study was to detail the variability of wound event definitions in recent ventral hernia literature and to propose standardized definitions for postoperative wound events following VHR.
Methods
The top 50 cited ventral hernia, peer-reviewed publications from 1995 through 2015 were identified using the search engine Google Scholar. The definition of wound event used and the incidence of postoperative wound events was recorded for each article. The number of articles that used a standardized definition for surgical site infection (SSI), surgical site occurrence (SSO), or surgical site occurrence requiring procedural intervention (SSOPI) was also identified.
Results
Of the 50 papers evaluated, only nine (18%) used a standardized definition for SSI, SSO, or SSOPI. The papers that used standardized definitions had a smaller variability in the incidence of wound events when compared to one another and their reported rates were more consistent with recently published ventral hernia repair literature.
Conclusion
Postoperative wound events following VHR are intimately associated with patient quality of life and long-term hernia repair durability. Standardization of the definition of postoperative wound events to include SSI, SSO, and SSOPI following VHR will improve the ability of hernia surgeons to make evidence-based decisions regarding the management of ventral hernias.
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References
Poulose BK, Shelton J, Phillips S et al (2012) Epidemiology and cost of ventral hernia repair: making the case for hernia research. Hernia 16(2):179–183
Ventral Hernia Working Group, Breuing K, Butler CE et al (2010) Incisional ventral hernias: review of the literature and recommendations regarding the grading and technique of repair. Surgery 148(3):544–558
Haskins IN, Amdur RL, Lin PP et al (2016) The use of mesh in emergent ventral hernia repair: effects on early patient morbidity and mortality. J Gastrointest Surg 20(11):1899–1903
Baucom RB, Ousley J, Oyefule OO et al (2016) evaluation of long-term surgical site occurrences in ventral hernia repair: implications of preoperative site independent MRSA infection. Hernia 20(5):701–710
Krpata DM, Blatnik JA, Novitsky YW et al (2013) Evaluation of high-risk, comorbid patients undergoing open ventral hernia repair with synthetic mesh. Surgery 153(1):120–125
Fischer JP, Wink JD, Nelson JA et al (2015) wound risk assessment in ventral hernia repair: generation and internal validation of risk stratification system using the ACS-NSQIP. Hernia 19(1):103–111
Finan KR, Cick CC, Kiefe CI et al (2005) Predictors of wound infection in ventral hernia repair. Am J Surg 190(5):676–681
Luijendijk RW, Hop WC, van den Tol MP et al (2000) A comparison of suture repair with mesh repair for incisional hernia. N Engl J Med 343(6):392–398
Cox TC, Blair LJ, Huntington CR et al (2016) The cost of preventable comorbidities on wound complications in open ventral hernia repair. J Surg Res 206(1):214–222
Frangou C (2014) Study reveals staggering costs of ventral hernia repair complication. General Surgery News. http://www.generalsurgerynews.com/In-the-News/Article/01-14/Study-Reveals-Staggering-Costs-of-Ventral-Hernia-Repair-Complication/24813/ses=ogst. Accessed 26 April 2017
Petro CC, O’Rourke CP, Posielski NM et al (2016) Designing a ventral hernia staging system. Hernia 20(1):111–117
Google scholar overview. https://scholar.google.com/intl/en/scholar/metrics.html#metrics. Accessed 19 May 2017
Surgical Site Infection (SSI) (2010) https://www.cdc.gov/hai/ssi/ssi.html. Accessed 26 April 2017
Surgical Site Infection (SSI) (2016) Event. http://www.cdc.gov/nhsn/pdfs/pscmanual/9pscssicurrent.pdf. Accessed 26 April 2017
Americas Hernia Society Quality Collaborative (2016) Qualified clinical data registry physician quality reporting system measure specifications. https://www.ahsqc.org/images/uploads/general_images/AHSQC_QCDR_Posting_to_website_4.27.16.pdf. Accessed 26 April 2017
ACS NSQIP participant user file. https://www.facs.org/quality-programs/acs-nsqip/program-specifics/participant-use. Accessed 19 May 2017
Dindo D, Demartines N, Clavien PA (2004) Classification of surgical complications. Ann Surg 240(2):205–213
Bruce J, Russell EM, Millison J et al (2001) The quality of measurement of surgical wound infection as the basis for monitoring: a systematic review. J Hosp Infect 49:99–108
Leaper D, Tanner J, Kiernan M (2013) Surveillance of surgical site infection: more accurate definitions and intensive recording needed. J Hosp Infect 83:83–86
Bassi C, Dervenis C, Butturini G et al (2005) Postoperative pancreatic fistula: an International Study Group (ISGPF) definition. Surgery 138(1):8–13
Bassi C, Marchegiani G, Dervenis C et al (2017) The 2016 update of the International Study Group (ISGPS) definition and grading of postoperative pancreatic fistula: 11 years after. Surgery 161(3):584–591
Kim H, Bruen K, Vargo D (2006) Acellular dermal matrix in the management of high-risk abdominal wall defects. Am J Surg 192(6):705–709
Finan KR, Vick CC, Kiefe CI et al (2005) Predictors of wound infection in ventral hernia repair. Am J Surg 190(5):676–681
Itani KM, Hur K, Kim LT et al (2010) Comparisons of laparoscopic and open repair with mesh for the treatment of ventral incisional hernia: a randomized trial. Arch Surg 145(4):322–328
Perrone JM, Soper NJ, Eagon JC et al (2005) Perioperative outcomes and complications of laparoscopic ventral hernia repair. Surgery 138(4):708–715
Choi JJ, Palaniappa NC, Dallas KB et al (2012) Use of mesh during ventral hernia repair in clean-contaminated and contaminated cases: outcomes of 33,832 cases. Ann Surg 255(1):176–180
Stretmitzer S, Bachleitner-Hoffman T, Gradl B et al (2010) Mesh graft infection following abdominal hernia repair: risk factor evaluation and strategies of mesh graft preservation. a retrospective analysis of 476 operations. World J Surg 34(7):1702–1709
Mason RJ, Maozzez A, Sohn HJ et al (2011) Laparoscopic versus open anterior abdominal wall hernia repair: 30-day morbidity and mortality using the acs-nsqip database. Ann Surg 254(4):641–652
Berger RL, Li LT, Hicks SC et al (2013) Development and validation of a risk-stratification score for surgical site occurrence and surgical site infection after open ventral hernia repair. J Am Coll Surg 217(6):974–982
Rogmark P, Pertersson U, Bringman S et al (2013) Short-term outcomes for open and laparoscopic midline incisional hernia repair: a randomized multicenter controlled trial: the ProLOVE (prospective randomized trial of open versus laparoscopic operation of ventral eventrations) trial. Ann Surg 258(1):37–45
Yamamoto T, Takahashi S, Ichihara K et al (2015) How do we understand the disagreement in the frequency of surgical site infection between the CDC and Clavien-Dindo classifications? J Infect Chemother 21:130–133
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INH: study concept, data acquisition, data analysis, data interpretation, manuscript writing. CMH: data acquisition, data analysis, data interpretation, manuscript writing. DMK: study concept, data interpretation, final manuscript review. ASP: study concept, data interpretation, final manuscript review. LT: data interpretation, final manuscript review. AJP: data interpretation, final manuscript writing. SR: data interpretation, final manuscript review. BKP: study concept, data analysis, data interpretation, final manuscript review. MJR: study concept, data analysis, data interpretation, final manuscript review.
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Conflict of interest
INH has a Resident Research Grant with the Americas Hernia Society unrelated to this work. ASP has a grant with Intuitive Surgical, receives salary support from Cooper Surgical, Bard Davol, and MedTronic unrelated to this work. BKP has received grant funding from Bard Davol and receives salary support from Artiste Medical, Pfizer, and AHSQC unrelated to this work. MJR is the Medical Director of and receives salary support from the AHSQC and he receives consulting fees from Bard and Gore, and has received grant funding from Miromatrix and Intuitive Surgical, Inc. unrelated to this work. CMH, DMK, LT, AJP and SR declares that they have no conflict of interest.
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No listed author received funding for this study. This study received Institutional Review Board exemption.
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This study does not contain any studies with human participants or animals performed by any of the authors.
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Haskins, I.N., Horne, C.M., Krpata, D.M. et al. A call for standardization of wound events reporting following ventral hernia repair. Hernia 22, 729–736 (2018). https://doi.org/10.1007/s10029-018-1748-6
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DOI: https://doi.org/10.1007/s10029-018-1748-6