Skin and soft tissue infection (SSTI) after hernia surgery is infrequent yet catastrophic and is associated with mesh infection, interventions, and hernia recurrence. Although hernia repair is one of the most common general surgery procedures, uncertainty persists regarding incidence of long-term infections. Our goal is to develop a machine learning regression model that detects the occurrence of long-term hernia-associated SSTI. The data set consisted of veterans receiving hernia repair with implanted synthetic mesh during 2008-2015. The outcome of interest was occurrence of SSTI related to the index hernia surgery over a five-year follow-up. A neural network regression was fit on a medical record reviewed sample, then applied to the study population. The study population was 96,435 surgeries, of which 76,886 (79.7%) were inguinal, 11,177 (11.6%) were umbilical, and 8,372 (8.7%) were ventral. In the training set, 40 patients had SSTI probability ≥90%, of whom 38 (95%) had a true SSTI. In 249 patients with SSTI probability <10%, only five (2%) patients had a true SSTI. In the testing set, nine patients were assigned a probability >90% and all were true-positives. In 100 patients with probability <10%, only two (2%) patients had a true infection. C-statistics were 0.929 in the training set and 0.901 in the testing set. The model showed excellent discrimination between those with and without infection and had good calibration. The model could be used to reduce the cost of detecting long-term infections.
Download full-text PDF |
Source |
---|---|
http://dx.doi.org/10.1089/sur.2020.354 | DOI Listing |
Polymers (Basel)
January 2025
Institute of Graduate Studies, Bioengineering Division, Tokat Gaziosmanpaşa University, 60250 Tokat, Türkiye.
Hernia repair is the most common surgical operation applied worldwide. Mesh prostheses are used to support weakened or damaged tissue to decrease the risk of hernia recurrence. However, the patches currently used in clinic applications have significant short-term and long-term risks.
View Article and Find Full Text PDFJ Clin Med
January 2025
Surgical Science Department, Plastic and Reconstructive Surgery Unit, "Pugliese-Ciaccio" Hospital, 88100 Catanzaro, Italy.
Incisional ventral hernia repair remains a challenging surgery for abdominal wall surgeons. We report the results at 48 months post-surgery regarding open ventral hernia repair (OVHR), analyzing the recurrence rate and incidence of chronic pain. This was a retrospective, observational study of 111 consecutive patients who underwent OVHR.
View Article and Find Full Text PDFSci Rep
January 2025
Department of Anesthesia and Pain Medicine, The First Affiliated Hospital of Chongqing Medical University, #1 Youyi Road, Yujiagang Community, Yuzhong District, Chongqing, 400016, China.
To optimize the efficacy of analgesia for patients receiving laparoscopic inguinal hernia repair, peri-operative pain neuroscience education (PNE) as a pain-specific cognitive therapy was incorporated into multi-modal analgesia. A randomized controlled trial was conducted to compare conventional analgesia (group CA) and the addition of pain neuroscience education into it (group PNE) in patients receiving laparoscopic inguinal hernia repair. Characteristics of peri-operative pain was evaluated with Douleur Neuropathique 4 questionnaire (DN-4), central sensitization inventory (CSI), pain catastrophizing scale (PCS) post-operatively and pressure pain threshold.
View Article and Find Full Text PDFWorld J Surg
January 2025
Dipartimento di Chirurgia Generale e Specialistica, Sapienza University of Rome, Rome, Italy.
Background: The history of inguinal hernia repair has been marked by the description of several therapies over ages, each with its own approach to managing the hernial sac. An analysis of hernia sac transection (with or without high ligation) versus reduction (invagination) in adults who underwent Lichtenstein open tension-free inguinal hernia repair and in adult and pediatric patients who underwent suture repair has been the primary aim of this systematic review and meta-analysis.
Methods: The authors conducted a comprehensive review and meta-analysis.
ANZ J Surg
January 2025
Department of General Surgery, Digestive Disease Hospital, Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou, China.
Objective: To explore independent risk factors and to establish a predictive model for postoperative urinary retention (POUR) following transabdominal preperitoneal inguinal hernia repair (TAPP).
Methods: Between January 2017 and December 2023, 598 patients with inguinal hernia who underwent TAPP at the General Surgery Department of Zunyi Medical University Affiliated Liupanshui Hospital were enrolled in the study. Participants were randomly divided into training and validation sets (7:3 ratio).
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!