Preoperative Chlorhexidine Gluconate Use Can Increase Risk for Surgical Site Infections after Ventral Hernia Repair - 19/04/17
, David M. Krpata, MD a, Sharon Phillips, MSPH b, Li-Ching Huang, PhD b, Ivy N. Haskins, MD a, Steven Rosenblatt, MD, FACS a, Benjamin K. Poulose, MD, FACS c, Michael J. Rosen, MD, FACS aAbstract |
Background |
There is varying evidence about the use of preoperative chlorhexidine gluconate to decrease surgical site infection for elective surgery. This intervention has never been studied in ventral hernia repair, the most common general surgery procedure in the US. We aimed to determine whether preoperative chlorhexidine gluconate decreases the risk of 30-day wound morbidity in patients undergoing ventral hernia repair.
Study Design |
All patients undergoing ventral hernia repair in the Americas Hernia Society Quality Collaborative were separated into 2 groups: 1 group received preoperative chlorhexidine scrub and the other did not. The 2 groups were evaluated for 30-day wound morbidity, including surgical site occurrence (SSO), surgical site infection (SSI), and SSO requiring procedural intervention. Statistical analysis was performed using multivariate regression analysis and propensity score modeling. Multiple factors were controlled for statistical analysis, including patient-related factors and operative factors.
Results |
In total, 3,924 patients were included for comparison. After multivariate logistic regression modeling, the preoperative chlorhexidine scrub group had a higher incidence of SSOs (odds ratio [OR] = 1.34; 95% CI 1.11 to 1.61) and SSIs (OR = 1.46; 95% CI 1.03 to 2.07). After propensity score modeling, the increased risk of SSO and SSI persisted (SSO: OR = 1.39; 95% CI 1.15 to 1.70; SSI: OR = 1.45; 95% CI 1.011 to 2.072, respectively).
Conclusions |
Prehospital chlorhexidine gluconate scrub appears to increase the risk of 30-day wound morbidity in patients undergoing ventral hernia repair. These findings suggest that the generalized use of prehospital chlorhexidine might not be desirable for all surgical populations.
Le texte complet de cet article est disponible en PDF.Abbreviations and Acronyms : AHSQC, CHG, NPCS, PCS, SSI, SSO, SSOPI
Plan
| Disclosure Information: Nothing to disclose. |
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| Disclosures outside the scope of this work: Dr Prabhu is a consultant for Medtronic and received grants from Davol, Miromatrix, and Intuitive Surgical. Dr Poulose is a consultant for Pfizer Medical. Dr Rosen is on the board of Artiste Medical, receives grants from Miromatrix, and payment for lectures from Bard and Davol. |
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| Support: Vanderbilt University received funds for the Americas Hernia Society Quality Collaborative (AHSQC) Data Coordination Center, Dr Poulose receives a salary as an employee of AHSQC, and Dr Rosen is employed by the AHSQC Foundation. |
Vol 224 - N° 3
P. 334-340 - mars 2017 Retour au numéro
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