Surgical site infection

the “Achilles Heel” of all types of abdominal wall hernia reconstruction

D. J. Tubre, A. D. Schroeder, J. Estes, J. Eisenga, Robert Joseph Fitzgibbons

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Purpose: Surgical site infection is the most common hospital-acquired infection in surgical patients. Recently, public health organizations have updated prevention guidelines. This review discusses surgical site infections as a complication of abdominal wall reconstruction. Methods: The authors reviewed guidelines on prevention of surgical site infections from the Center for Disease Control and Prevention, World Health Organization, and National Institute for Health and Care Excellence and put them into context with the relevant abdominal wall reconstruction literature. This was the subject of the Nyhus–Wantz lecture given at The International Hernia Congress on March 14, 2018 in Miami, FL and is summarized here. Results: Routine use of preoperative antibiotics in prosthetic groin hernia repair is not supported by the available literature. High-quality data on antibiotic prophylaxis in ventral (both primary and incisional) hernia repair is lacking, but it is widely utilized and may reduce SSIs. Recommended preventative strategies discussed in this manuscript include: treatment of remote site infections, perioperative normothermia and normoglycemia, avoidance of hypoxemia, antiseptic preparation of surgical team hands and patient skin, treatment of obesity, smoking cessation, correction of malnutrition, and physical conditioning. Conclusion: Surgical site infections lead to significant morbidity and mortality, hernia recurrences, prolonged hospital stay, and increased hospital costs. This makes surgical site infections the “Achilles Heel” of abdominal wall reconstruction. Strict adherence to standardized guidelines and preoperative optimization of patients’ risk profiles are crucial to decrease the incidence of surgical site infections.

Original languageEnglish (US)
JournalHernia
DOIs
StateAccepted/In press - Jan 1 2018

Fingerprint

Abdominal Hernia
Surgical Wound Infection
Abdominal Wall
Herniorrhaphy
Guidelines
Hernia
Local Anti-Infective Agents
Antibiotic Prophylaxis
Groin
Hospital Costs
National Institutes of Health (U.S.)
Smoking Cessation
Centers for Disease Control and Prevention (U.S.)
Cross Infection
Malnutrition
Length of Stay
Hand
Public Health
Obesity
Organizations

All Science Journal Classification (ASJC) codes

  • Surgery

Cite this

Surgical site infection : the “Achilles Heel” of all types of abdominal wall hernia reconstruction. / Tubre, D. J.; Schroeder, A. D.; Estes, J.; Eisenga, J.; Fitzgibbons, Robert Joseph.

In: Hernia, 01.01.2018.

Research output: Contribution to journalArticle

@article{0a8020db4f54405a879cd62bf18c8c40,
title = "Surgical site infection: the “Achilles Heel” of all types of abdominal wall hernia reconstruction",
abstract = "Purpose: Surgical site infection is the most common hospital-acquired infection in surgical patients. Recently, public health organizations have updated prevention guidelines. This review discusses surgical site infections as a complication of abdominal wall reconstruction. Methods: The authors reviewed guidelines on prevention of surgical site infections from the Center for Disease Control and Prevention, World Health Organization, and National Institute for Health and Care Excellence and put them into context with the relevant abdominal wall reconstruction literature. This was the subject of the Nyhus–Wantz lecture given at The International Hernia Congress on March 14, 2018 in Miami, FL and is summarized here. Results: Routine use of preoperative antibiotics in prosthetic groin hernia repair is not supported by the available literature. High-quality data on antibiotic prophylaxis in ventral (both primary and incisional) hernia repair is lacking, but it is widely utilized and may reduce SSIs. Recommended preventative strategies discussed in this manuscript include: treatment of remote site infections, perioperative normothermia and normoglycemia, avoidance of hypoxemia, antiseptic preparation of surgical team hands and patient skin, treatment of obesity, smoking cessation, correction of malnutrition, and physical conditioning. Conclusion: Surgical site infections lead to significant morbidity and mortality, hernia recurrences, prolonged hospital stay, and increased hospital costs. This makes surgical site infections the “Achilles Heel” of abdominal wall reconstruction. Strict adherence to standardized guidelines and preoperative optimization of patients’ risk profiles are crucial to decrease the incidence of surgical site infections.",
author = "Tubre, {D. J.} and Schroeder, {A. D.} and J. Estes and J. Eisenga and Fitzgibbons, {Robert Joseph}",
year = "2018",
month = "1",
day = "1",
doi = "10.1007/s10029-018-1826-9",
language = "English (US)",
journal = "Hernia : the journal of hernias and abdominal wall surgery",
issn = "1265-4906",
publisher = "Springer Paris",

}

TY - JOUR

T1 - Surgical site infection

T2 - the “Achilles Heel” of all types of abdominal wall hernia reconstruction

AU - Tubre, D. J.

AU - Schroeder, A. D.

AU - Estes, J.

AU - Eisenga, J.

AU - Fitzgibbons, Robert Joseph

PY - 2018/1/1

Y1 - 2018/1/1

N2 - Purpose: Surgical site infection is the most common hospital-acquired infection in surgical patients. Recently, public health organizations have updated prevention guidelines. This review discusses surgical site infections as a complication of abdominal wall reconstruction. Methods: The authors reviewed guidelines on prevention of surgical site infections from the Center for Disease Control and Prevention, World Health Organization, and National Institute for Health and Care Excellence and put them into context with the relevant abdominal wall reconstruction literature. This was the subject of the Nyhus–Wantz lecture given at The International Hernia Congress on March 14, 2018 in Miami, FL and is summarized here. Results: Routine use of preoperative antibiotics in prosthetic groin hernia repair is not supported by the available literature. High-quality data on antibiotic prophylaxis in ventral (both primary and incisional) hernia repair is lacking, but it is widely utilized and may reduce SSIs. Recommended preventative strategies discussed in this manuscript include: treatment of remote site infections, perioperative normothermia and normoglycemia, avoidance of hypoxemia, antiseptic preparation of surgical team hands and patient skin, treatment of obesity, smoking cessation, correction of malnutrition, and physical conditioning. Conclusion: Surgical site infections lead to significant morbidity and mortality, hernia recurrences, prolonged hospital stay, and increased hospital costs. This makes surgical site infections the “Achilles Heel” of abdominal wall reconstruction. Strict adherence to standardized guidelines and preoperative optimization of patients’ risk profiles are crucial to decrease the incidence of surgical site infections.

AB - Purpose: Surgical site infection is the most common hospital-acquired infection in surgical patients. Recently, public health organizations have updated prevention guidelines. This review discusses surgical site infections as a complication of abdominal wall reconstruction. Methods: The authors reviewed guidelines on prevention of surgical site infections from the Center for Disease Control and Prevention, World Health Organization, and National Institute for Health and Care Excellence and put them into context with the relevant abdominal wall reconstruction literature. This was the subject of the Nyhus–Wantz lecture given at The International Hernia Congress on March 14, 2018 in Miami, FL and is summarized here. Results: Routine use of preoperative antibiotics in prosthetic groin hernia repair is not supported by the available literature. High-quality data on antibiotic prophylaxis in ventral (both primary and incisional) hernia repair is lacking, but it is widely utilized and may reduce SSIs. Recommended preventative strategies discussed in this manuscript include: treatment of remote site infections, perioperative normothermia and normoglycemia, avoidance of hypoxemia, antiseptic preparation of surgical team hands and patient skin, treatment of obesity, smoking cessation, correction of malnutrition, and physical conditioning. Conclusion: Surgical site infections lead to significant morbidity and mortality, hernia recurrences, prolonged hospital stay, and increased hospital costs. This makes surgical site infections the “Achilles Heel” of abdominal wall reconstruction. Strict adherence to standardized guidelines and preoperative optimization of patients’ risk profiles are crucial to decrease the incidence of surgical site infections.

UR - http://www.scopus.com/inward/record.url?scp=85054317137&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85054317137&partnerID=8YFLogxK

U2 - 10.1007/s10029-018-1826-9

DO - 10.1007/s10029-018-1826-9

M3 - Article

JO - Hernia : the journal of hernias and abdominal wall surgery

JF - Hernia : the journal of hernias and abdominal wall surgery

SN - 1265-4906

ER -