Predictors of wound infection in ventral hernia repair
Department of Quantitative Health Sciences
Medical Subject Headings
Adult; Aged; Aged, 80 and over; Female; Follow-Up Studies; Hernia, Ventral; Hospitals, Veterans; Humans; Incidence; Male; Middle Aged; Prognosis; Recurrence; Retrospective Studies; Risk Factors; Smoking; Smoking Cessation; Surgical Wound Infection; Treatment Outcome; United States; United States Department of Veterans Affairs
Bioinformatics | Biostatistics | Epidemiology | Health Services Research
BACKGROUND: Postoperative wound infection is a significant risk factor for recurrence after ventral hernia repair (VHR). The current study examines patient- and procedure-specific variables associated with wound infection.
METHODS: A cohort of subjects undergoing VHR from 13 regional Veterans Health Administration (VHA) sites was identified. Patient-specific risk variables were obtained from National Surgical Quality Improvement Program (NSQIP) data. Operative variables were obtained from physician-abstracted operative notes. Univariate and multivariable logistic regression analysis was used to model predictors of postoperative wound infection.
RESULTS: A total of 1505 VHR cases were used for analysis; wound infection occurred in 5% (n = 74). Best-fit logistic regression models demonstrated that steroid use, smoking, prolonged operative time, and use of absorbable mesh, acting as a surrogate marker for a more complex procedure, were significant independent predictors of wound infection.
CONCLUSION: Permanent mesh placement was not associated with postoperative wound infection. Smoking was the only modifiable risk factor and preoperative smoking cessation may improve surgical outcomes in VHR.
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Citation: Am J Surg. 2005 Nov;190(5):676-81. Link to article on publisher's site