The European Hernia Society Prehabilitation Project: A Systematic Review of Intra-Operative Prevention Strategies for Surgical Site Occurrences in Ventral Hernia Surgery.

abdominal wall repair hernia prevention surgical site infection surgical site occurrence

Journal

Frontiers in surgery
ISSN: 2296-875X
Titre abrégé: Front Surg
Pays: Switzerland
ID NLM: 101645127

Informations de publication

Date de publication:
2022
Historique:
received: 01 01 2022
accepted: 06 06 2022
entrez: 1 8 2022
pubmed: 2 8 2022
medline: 2 8 2022
Statut: epublish

Résumé

Ventral hernia repair is one of the most commonly performed surgical procedures worldwide. To reduce the risk of complications, pre- and intra-operative strategies have received increasing focus in recent years. To assess possible preventive surgical strategies, this European Hernia Society endorsed project was launched. The aim of this review was to evaluate the current literature focusing on pre- and intra-operative strategies for surgical site occurrences (SSO) and specifically surgical site infection (SSI) in ventral hernia repair. A systematic review was conducted and reported in line with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. Databases used were Pubmed and Web of Science. Original retrospective or prospective human adult studies describing at least one intra-operative intervention to reduce SSO after ventral hernia repair were considered eligible. From a total of 4775 results, a total of 18 papers were considered suitable after full text reading. Prehospital chlorhexidine gluconate (CHG) scrub appears to increase the risk of SSO in patients undergoing ventral hernia repair, while there is no association between any type of surgical hat worn and the incidence of postoperative wound events. Intraoperative measures as prophylactic negative pressure therapy, surgical drain placement and the use of quilt sutures seem beneficial for decreasing the incidence of SSO and/or SSI. No positive effect has been shown for antibiotic soaking of a synthetic mesh, nor for the use of fibrin sealants. This review identified a limited amount of literature describing specific preventive measures and techniques during ventral hernia repair. An advantage of prophylactic negative pressure therapy in prevention of SSI was observed, but different tools to decrease SSIs and SSOs continuously further need our full attention to improve patient outcomes and to lower overall costs.

Sections du résumé

Background UNASSIGNED
Ventral hernia repair is one of the most commonly performed surgical procedures worldwide. To reduce the risk of complications, pre- and intra-operative strategies have received increasing focus in recent years. To assess possible preventive surgical strategies, this European Hernia Society endorsed project was launched. The aim of this review was to evaluate the current literature focusing on pre- and intra-operative strategies for surgical site occurrences (SSO) and specifically surgical site infection (SSI) in ventral hernia repair.
Methods UNASSIGNED
A systematic review was conducted and reported in line with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. Databases used were Pubmed and Web of Science. Original retrospective or prospective human adult studies describing at least one intra-operative intervention to reduce SSO after ventral hernia repair were considered eligible.
Results UNASSIGNED
From a total of 4775 results, a total of 18 papers were considered suitable after full text reading. Prehospital chlorhexidine gluconate (CHG) scrub appears to increase the risk of SSO in patients undergoing ventral hernia repair, while there is no association between any type of surgical hat worn and the incidence of postoperative wound events. Intraoperative measures as prophylactic negative pressure therapy, surgical drain placement and the use of quilt sutures seem beneficial for decreasing the incidence of SSO and/or SSI. No positive effect has been shown for antibiotic soaking of a synthetic mesh, nor for the use of fibrin sealants.
Conclusion UNASSIGNED
This review identified a limited amount of literature describing specific preventive measures and techniques during ventral hernia repair. An advantage of prophylactic negative pressure therapy in prevention of SSI was observed, but different tools to decrease SSIs and SSOs continuously further need our full attention to improve patient outcomes and to lower overall costs.

Identifiants

pubmed: 35910469
doi: 10.3389/fsurg.2022.847279
pmc: PMC9326087
doi:

Types de publication

Journal Article Review

Langues

eng

Pagination

847279

Informations de copyright

Copyright © 2022 Wouters, Cavallaro, Jensen, East, Jíšová, Jorgensen, López-Cano, Rodrigues-Gonçalves, Stabilini and Berrevoet.

Déclaration de conflit d'intérêts

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

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Auteurs

D Wouters (D)

Department for General and HPB Surgery and Liver Transplantation, University Hospital Gent, Gent, Belgium.

G Cavallaro (G)

Department for General and HPB Surgery and Liver Transplantation, University Hospital Gent, Gent, Belgium.

Kristian K Jensen (KK)

Digestive Disease Center, Bispebjerg Hospital, University of Copenhagen, Copenhagen, Denmark.

B East (B)

3rd Department of Surgery and 1st Medical Faculty of Charles University, Motol University Hospital, Prague, Czech Republic.

B Jíšová (B)

3rd Department of Surgery and 1st Medical Faculty of Charles University, Motol University Hospital, Prague, Czech Republic.

L N Jorgensen (LN)

Digestive Disease Center, Bispebjerg Hospital, University of Copenhagen, Copenhagen, Denmark.

M López-Cano (M)

Abdominal Wall Surgery Unit, Department of General Surgery, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain.

V Rodrigues-Gonçalves (V)

Abdominal Wall Surgery Unit, Department of General Surgery, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain.

C Stabilini (C)

Department of Surgery, University of Genoa, Genoa, Italy.
European Hernia Society, Ospedale Policlinico San Martino IRCCS, Genoa, Italy.

F Berrevoet (F)

Department for General and HPB Surgery and Liver Transplantation, University Hospital Gent, Gent, Belgium.

Classifications MeSH