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Validation of ventral hernia risk score in predicting surgical site infections

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Abstract

Purpose

Ventral hernia risk score (VHRS) is a risk assessment tool for predicting the development of surgical site infection (SSI) developed in the Veterans Affairs population by Berger et al. The score was externally validated by the same study group in a diverse population in another study. It was also shown to be better than the existing Centre for Diseases (CDC) wound class and Ventral Hernia Working Group (VHWG) models. Our study aims to test the performance of the score in an Asian-Indian population.

Methods

A prospective database of ventral hernia repairs done in a tertiary care centre between February 2019 and December 2020 was utilized for the study. All patients with a minimum follow-up of 1-month period were included in the study. The CDC definition of SSI was used. The VHRS, VHWG, and CDC class of each of the patients was determined. Receiver-Operating curves (ROC) of the scores and area under the curves (AUC) were used to compare the three scores.

Results

A total of 120 patients were included. During the course of our study, a total of 33 patients developed SSI (27.5%). Important factors which seemed to predict SSI were median operating time, CDC incision class, concomitant hernia repair, and creating skin flaps. The AUC of the VHRS score was 0.76 which was higher than those of VHWG (0.61) and CDC (0.58).

Conclusion

Our study externally validates the novel VHRS which outperforms both CDC incision class and VHWG in predicting SSI following open ventral hernia repair, especially in a group with lower BMI compared to the previous reports.

Trial registration No CTRI/2020/07/026289 registered on 01/07/2020.

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Acknowledgements

The authors would like to thank Dr. Stuti Pramod, Junior Resident, Department of Preventive and Social Medicine (PSM), Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Pondicherry, India, for her help in the statistical analysis

Funding

Nil.

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Authors and Affiliations

Authors

Contributions

SA did the acquisition and analysis of the data; AA contributed to the conception and design of the research, interpretation of the data; SS contributrd in analysis and interpretation of data, drafting the manuscript. All authors critically revised the manuscript, agree to be fully accountable for ensuring the integrity and accuracy of the work, and read and approved the final manuscript.

Corresponding author

Correspondence to A. Anandhi.

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Conflict of interest

Subramaniyan Ashuvanth, Amaranathan Anandhi and Sathasivam Sureshkumar don’t have any conflict of interest.

Ethical approval

The study was approved by the institutional ethics committee (JIP/IEC/2018/484). This trail was registered in Clinical Trail Registry India (CTRI/2020/07/026289).

Human and animal rights

This article does not contain any studies with animals performed by any of the authors.

Informed consent

All patients undergoing open ventral hernia repair between February 2019 and December 2020 were enrolled for the study after obtaining informed consent.

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Ashuvanth, S., Anandhi, A. & Sureshkumar, S. Validation of ventral hernia risk score in predicting surgical site infections. Hernia 26, 911–917 (2022). https://doi.org/10.1007/s10029-021-02537-y

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  • DOI: https://doi.org/10.1007/s10029-021-02537-y

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