Randomized Controlled Trial on Preventing of Surgical Site Infection of Tension-free Repair of Inguinal Hernias with A Bundled Intervention

Objective To explore a bundled intervention (preoperative chlorhexidine bath, electric skin preparation, skin preparation on the day of surgery, skin disinfectant with chlorhexidine compound) for prevention surgical site infection (SSI) of inguinal hernia repair. Methods From December 2016 to October 2017, 125 patients with inguinal hernia in Sichuan Provincial People's Hospital were enrolled. Of these, 117 (93.6%) completed the study. Patients with inguinal hernia repair were divided into intervention group and control group according to random number table method. 54 patients in the intervention group were treated with the bundled intervention; 63 patients in the control group were treated with conventional measures. The incidence of SSI and the medical cost of the two groups were observed and compared. Results The incidence of SSI was 3.70% (2/54) in the intervention group and 12.70% (8/63) in the control group. There was no significant difference between the two groups (χ2=1.969, P=0.161). The average hospital stay was 7 days (4 to 32 days) in the intervention group, and the control group was 8 days (3 to 45 days). The difference between the two groups was statistically significant (Z=-1.995, P=0.046). The average treatment cost of the intervention group was 10 655 yuan (7 295.51 to 28 917.02) yuan, the control group was 11 737.96 yuan (7 953.61 to 24 103.04) yuan, and the difference between the two groups was statistically significant (Z=-2.433, P=0.015). Conclusion The bundled intervention has not been observed to significantly reduce the incidence of SSI in inguinal hernia repair, and its effectiveness needs further study. However, the bundled intervention can effectively shorten the average length of hospital stay and average treatment cost for patients with inguinal hernia. Key words: Hernia, groin; Herniorrhaphy; Surgical site infection; Bundled intervention