Does Preoperative Bowel Preparation Reduce Surgical Site Infections During Elective Ventral Hernia Repair?
BACKGROUND
To date, little is known about the benefits of preoperative bowel preparation in patients undergoing elective ventral hernia repair (VHR). The purpose of this study was to determine the effect of preoperative bowel preparation on 30-day wound events in patients undergoing elective VHR using the Americas Hernia Society Quality Collaborative (AHSQC).


METHODS
All patients undergoing elective VHR from January 2013 through January 2016 were identified within the AHSQC. Patients undergoing emergency VHR and those with a CDC wound class IV were excluded from our analysis. Patients were divided into 2 groups: Clean (CDC wound class I) and Contaminated (CDC wound classes II and III). The association of preoperative bowel preparation with 30-day wound events was investigated using logistic regression modeling.


RESULTS
A total of 3,709 patients met inclusion criteria; 3,101 (83.6%) had CDC wound class I, and 608 (16.4%) had CDC wound classes II or III. Within the Clean group, patients who underwent preoperative bowel preparation were significantly more likely to experience a surgical site infection (SSI), surgical site occurrence (SSO), and surgical site occurrence requiring procedural intervention (SSOPI). Within the Contaminated group, patients who underwent preoperative bowel preparation were significantly more likely to experience an SSOPI.


CONCLUSIONS
The use of preoperative bowel preparation in patients undergoing elective VHR does not reduce the risk of 30-day wound events.
Comprehensive Hernia Center, Digestive Disease and Surgical Institute, The Cleveland Clinic Foundation, Cleveland, OH. Electronic address: krpatad@ccf.org.
David M
DM
Krpata
Comprehensive Hernia Center, Digestive Disease and Surgical Institute, The Cleveland Clinic Foundation, Cleveland, OH.
Ivy N
IN
Haskins
Department of Biostatistics, Vanderbilt University Medical Center, Nashville, TN.
Sharon
S
Phillips
Comprehensive Hernia Center, Digestive Disease and Surgical Institute, The Cleveland Clinic Foundation, Cleveland, OH.
Ajita S
AS
Prabhu
Comprehensive Hernia Center, Digestive Disease and Surgical Institute, The Cleveland Clinic Foundation, Cleveland, OH.
Steven
S
Rosenblatt
Division of General Surgery, Vanderbilt University Medical Center, Nashville, TN.
Benjamin K
BK
Poulose
Comprehensive Hernia Center, Digestive Disease and Surgical Institute, The Cleveland Clinic Foundation, Cleveland, OH.
Michael J
MJ
Rosen
D000328:Adult; D000368:Aged; D002400:Cathartics / Q000627:therapeutic use*; D017558:Elective Surgical Procedures; D005260:Female; D005500:Follow-Up Studies; D006555:Hernia, Ventral / Q000601:surgery*; D059685:Herniorrhaphy; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011300:Preoperative Care / Q000379:methods*; D012042:Registries; D012189:Retrospective Studies; D013530:Surgical Wound Infection / Q000453:epidemiology / Q000517:prevention & control*; D016896:Treatment Outcome
D002400:Cathartics