Berger et al developed the Ventral Hernia Risk Score (VHRS) to identify patients at risk for surgical site occurrence and surgical site infection following ventral hernia repair. The authors are from the Micheal E. DeBakey Veterans Affairs Medicial Center, Baylor College of Medicine, Rice University and the University of Texas at Houston.
Patient selection: ventral hernia repair (umbilical, incisional, epigastric, parastomal, Spigelian)
Parameters:
(1) body mass index (BMI)
(2) ASA score
(3) skin flap
(4) concomitant hernia repair (with laparoscopic cholecystectomy, exploratory laparotomy, ostomy reversal, or some other surgical procedure)
(5) surgical wound class
|
Parameters |
Findings |
Points |
|
body mass index |
< 40 kg per sq m |
0 |
|
|
>= 40 kg per sq m |
3 |
|
ASA score |
1 or 2 |
0 |
|
|
3, 4 or 5 |
2 |
|
skin flap |
no |
0 |
|
|
yes |
2 |
|
concomitant hernia repair |
no |
0 |
|
|
yes |
2 |
|
surgical wound class |
1, 2 or 3 |
0 |
|
|
4 (dirty, infected) |
7 |
where:
• There are probably not very many hernia repairs with ASA Class 5.
total score =
= SUM(points for all 5 parameters)
Interpretation:
• minimum score: 0
• maximum score: 16
• The higher the score the greater the risk for surgical site occurrence and for surgical site infection.
|
VHRS |
Percent with Surgical Site Occurrence |
|
0 |
18% |
|
2, 3 or 4 |
50% (moderate risk) |
|
5 to 16 |
80% (high risk) |
|
VHRS |
Percent with Surgical Site Occurrence |
|
0 |
8% |
|
2 or 3 |
18% |
|
4 |
28% |
|
5 to 10 |
53% |
|
11 to 16 |
83% |
Specialty: Infectious Diseases
ICD-10: ,
