OBJECTIVE: To investigate whether operative factors are associated with risk of surgical site infection (SSI) after hernia repair. DESIGN: Retrospective cohort study. Patients Commercially insured enrollees aged 6 months-64 years with International Classification of Diseases, Ninth Revision, Clinical Modification procedure or Current Procedural Terminology, fourth edition, codes for inguinal/femoral, umbilical, and incisional/ventral hernia repair procedures from January 1, 2004, through December 31, 2010. METHODS: SSIs within 90 days after hernia repair were identified by diagnosis codes. The χ2 and Fisher exact tests were used to compare SSI incidence by operative factors. RESULTS: A total of 119,973 hernia repair procedures were analyzed. The incidence of SSI differed significantly by anatomic site, with rates of 0.45% (352/77,666) for inguinal/femoral, 1.16% (288/24,917) for umbilical, and 4.11% (715/17,390) for incisional/ventral hernia repair. Within anatomic sites, the incidence of SSI was significantly higher for open versus laparoscopic inguinal/femoral (0.48% [295/61,142] vs 0.34% [57/16,524], P=.020) and incisional/ventral (4.20% [701/16,699] vs 2.03% [14/691], P=.005) hernia repairs. The rate of SSI was higher following procedures with bowel obstruction/necrosis than procedures without obstruction/necrosis for open inguinal/femoral (0.89% [48/5,422] vs 0.44% [247/55,720], P<.001) and umbilical (1.57% [131/8,355] vs 0.95% [157/16,562], P<.001), but not incisional/ventral hernia repair (4.01% [224/5,585] vs 4.16% [491/11,805], P=.645). CONCLUSIONS: The incidence of SSI was highest after open procedures, incisional/ventral repairs, and hernia repairs with bowel obstruction/necrosis. Stratification of hernia repair SSI rates by some operative factors may facilitate accurate comparison of SSI rates between facilities.
OBJECTIVE: To investigate whether operative factors are associated with risk of surgical site infection (SSI) after hernia repair. DESIGN: Retrospective cohort study. Patients Commercially insured enrollees aged 6 months-64 years with International Classification of Diseases, Ninth Revision, Clinical Modification procedure or Current Procedural Terminology, fourth edition, codes for inguinal/femoral, umbilical, and incisional/ventral hernia repair procedures from January 1, 2004, through December 31, 2010. METHODS: SSIs within 90 days after hernia repair were identified by diagnosis codes. The χ2 and Fisher exact tests were used to compare SSI incidence by operative factors. RESULTS: A total of 119,973 hernia repair procedures were analyzed. The incidence of SSI differed significantly by anatomic site, with rates of 0.45% (352/77,666) for inguinal/femoral, 1.16% (288/24,917) for umbilical, and 4.11% (715/17,390) for incisional/ventral hernia repair. Within anatomic sites, the incidence of SSI was significantly higher for open versus laparoscopic inguinal/femoral (0.48% [295/61,142] vs 0.34% [57/16,524], P=.020) and incisional/ventral (4.20% [701/16,699] vs 2.03% [14/691], P=.005) hernia repairs. The rate of SSI was higher following procedures with bowel obstruction/necrosis than procedures without obstruction/necrosis for open inguinal/femoral (0.89% [48/5,422] vs 0.44% [247/55,720], P<.001) and umbilical (1.57% [131/8,355] vs 0.95% [157/16,562], P<.001), but not incisional/ventral hernia repair (4.01% [224/5,585] vs 4.16% [491/11,805], P=.645). CONCLUSIONS: The incidence of SSI was highest after open procedures, incisional/ventral repairs, and hernia repairs with bowel obstruction/necrosis. Stratification of hernia repair SSI rates by some operative factors may facilitate accurate comparison of SSI rates between facilities.
Authors: Christodoulos Kaoutzanis; Stefan W Leichtle; Nicolas J Mouawad; Kathleen B Welch; Richard M Lampman; Robert K Cleary Journal: Surg Endosc Date: 2013-02-07 Impact factor: 4.584
Authors: Buckminster Farrow; Samir Awad; David H Berger; Daniel Albo; Liz Lee; Anu Subramanian; Charles F Bellows Journal: Am J Surg Date: 2008-11 Impact factor: 2.565
Authors: Leigh Neumayer; Anita Giobbie-Hurder; Olga Jonasson; Robert Fitzgibbons; Dorothy Dunlop; James Gibbs; Domenic Reda; William Henderson Journal: N Engl J Med Date: 2004-04-25 Impact factor: 91.245
Authors: John Shepard; William Ward; Aaron Milstone; Taylor Carlson; John Frederick; Eric Hadhazy; Trish Perl Journal: JAMA Surg Date: 2013-10 Impact factor: 14.766
Authors: J M McGreevy; P P Goodney; C M Birkmeyer; S R G Finlayson; W S Laycock; J D Birkmeyer Journal: Surg Endosc Date: 2003-09-10 Impact factor: 4.584
Authors: David K Warren; Katelin B Nickel; Anna E Wallace; Daniel Mines; Fang Tian; William J Symons; Victoria J Fraser; Margaret A Olsen Journal: Open Forum Infect Dis Date: 2017-02-22 Impact factor: 3.835