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Increased use of surgical energy promotes methicillin-resistant Staphylococcus aureus colonization in rabbits following open ventral hernia mesh repair.

Publication ,  Journal Article
Fernandez-Moure, JS; Van Eps, JL; Peress, L; Cantu, C; Olsen, RJ; Jenkins, L; Cabrera, FJ; Tasciotti, E; Weiner, BK; Dunkin, BJ
Published in: Surg Endosc
February 2017

BACKGROUND: Surgical energy has been widely implemented because of ease of use, effective hemostasis, and surgical dissection. Studies demonstrate its use to be an independent risk factor for postoperative wound infection. Methicillin-resistant Staphylococcus aureus (MRSA) is the most common bacteria found in postoperative mesh infection. No reports are available on the sequelae of surgical energy use for open ventral hernia repair (oVHR) with mesh. We hypothesized that increasing amounts of surgical energy will result in higher infectious burden after oVHR with composite multifilament polyester mesh (Parietex™ PCO). METHODS: New Zealand rabbits underwent bridging oVHR with Parietex™ PCO and were divided into three surgical treatment groups: (1) scalpel alone, (2) 120 J of energy, and (3) 600 J of energy. The bioprosthesis was then inoculated with 105 colony-forming units of MRSA. Rabbits were survived for 7 days with daily physical examination. Complete blood count, basci metabolic panel, and blood cultures were performed on postoperative days one, four, and seven. Surviving rabbits were killed, and meshes explanted for MRSA colony counts. RESULTS: Rabbits receiving the most surgical energy developed signs and symptoms of severe sepsis and wound necrosis within 24 h. In comparison, rabbits receiving no surgical energy had significantly less MRSA recovered from explanted mesh, significantly less bacteremia, and fewer adhesions. CONCLUSIONS: Increased use of surgical energy promoted greater colonization, exaggerated septic response to bacterial contamination, and more severe adhesions. In the absence of devitalized tissue, rabbits can effectively limit bacterial contamination. These findings support the surgical principles of proper tissue handling and highlight the detrimental effects of indiscriminant surgical energy usage, thus emphasizing the importance of programs such as Fundamental Use of Surgical Energy.

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Published In

Surg Endosc

DOI

EISSN

1432-2218

Publication Date

February 2017

Volume

31

Issue

2

Start / End Page

852 / 860

Location

Germany

Related Subject Headings

  • Surgical Wound Infection
  • Surgical Mesh
  • Surgery
  • Staphylococcal Infections
  • Sepsis
  • Risk Factors
  • Rabbits
  • Prosthesis-Related Infections
  • Polyesters
  • Methicillin-Resistant Staphylococcus aureus
 

Citation

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Fernandez-Moure, J. S., Van Eps, J. L., Peress, L., Cantu, C., Olsen, R. J., Jenkins, L., … Dunkin, B. J. (2017). Increased use of surgical energy promotes methicillin-resistant Staphylococcus aureus colonization in rabbits following open ventral hernia mesh repair. Surg Endosc, 31(2), 852–860. https://doi.org/10.1007/s00464-016-5043-2
Fernandez-Moure, Joseph S., Jeffrey L. Van Eps, Lilia Peress, Concepcion Cantu, Randall J. Olsen, Leslie Jenkins, Fernando J. Cabrera, Ennio Tasciotti, Bradley K. Weiner, and Brian J. Dunkin. “Increased use of surgical energy promotes methicillin-resistant Staphylococcus aureus colonization in rabbits following open ventral hernia mesh repair.Surg Endosc 31, no. 2 (February 2017): 852–60. https://doi.org/10.1007/s00464-016-5043-2.
Fernandez-Moure JS, Van Eps JL, Peress L, Cantu C, Olsen RJ, Jenkins L, et al. Increased use of surgical energy promotes methicillin-resistant Staphylococcus aureus colonization in rabbits following open ventral hernia mesh repair. Surg Endosc. 2017 Feb;31(2):852–60.
Fernandez-Moure, Joseph S., et al. “Increased use of surgical energy promotes methicillin-resistant Staphylococcus aureus colonization in rabbits following open ventral hernia mesh repair.Surg Endosc, vol. 31, no. 2, Feb. 2017, pp. 852–60. Pubmed, doi:10.1007/s00464-016-5043-2.
Fernandez-Moure JS, Van Eps JL, Peress L, Cantu C, Olsen RJ, Jenkins L, Cabrera FJ, Tasciotti E, Weiner BK, Dunkin BJ. Increased use of surgical energy promotes methicillin-resistant Staphylococcus aureus colonization in rabbits following open ventral hernia mesh repair. Surg Endosc. 2017 Feb;31(2):852–860.
Journal cover image

Published In

Surg Endosc

DOI

EISSN

1432-2218

Publication Date

February 2017

Volume

31

Issue

2

Start / End Page

852 / 860

Location

Germany

Related Subject Headings

  • Surgical Wound Infection
  • Surgical Mesh
  • Surgery
  • Staphylococcal Infections
  • Sepsis
  • Risk Factors
  • Rabbits
  • Prosthesis-Related Infections
  • Polyesters
  • Methicillin-Resistant Staphylococcus aureus