The implementation of an enhanced recovery pathway after giant ventral hernia repair, including preoperative high-dose steroid is examined prospectively and compared with a group of historic controls.
All patients operated on for a large incisional hernia are treated according to the study protocol. Patients are given high-dose glucocorticoid preoperative and the aim is to discharge patients at postoperative day 3. Morbidity, length of stay, pain, nausea and pulmonary function are among registered outcomes compared with a historic control group.
Study Type
OBSERVATIONAL
Enrollment
32
Enhanced recovery after surgery pathway. Postoperatively, a set of well-defined discharge criteria will be assessed daily at 9:00 and 15:00, as well as pain, nausea, time to flatus, saturation and drain production.
Bispebjerg Hospital
Copenhagen NV, Copenhagen, Denmark
Time to discharge
Time from surgery to discharge \[Hours\].
Time frame: Participants will be followed for the duration of hospital stay, an expected average of 72 hours
Fatigue
Preoperative and twice daily (9 and 15) postoperative. Measured by a numerical rating scale (1 = No fatigue, 5 = Exhausted).
Time frame: Preoperative and for the duration of hospital stay, an expected average of 3 days
Pain from supine to standing
Preoperative and twice daily (9 and 15) postoperative. Measured by a numerical rating scale (1 = No pain, 5 = Intolerable pain)
Time frame: Preoperative and for the duration of hospital stay, an expected average of 3 days
Pain when walking 6 meters
Preoperative and twice daily (9 and 15) postoperative. Measured by a numerical rating scale (1 = No pain, 5 = Intolerable pain)
Time frame: Preoperative and for the duration of hospital stay, an expected average of 3 days
Nausea
Preoperative and twice daily (9 and 15) postoperative. Measured by a numerical rating scale (1 = No nausea, 5 = Intolerable nausea)
Time frame: Preoperative and for the duration of hospital stay, an expected average of 3 days
Time to bowel function
The time to bowel function \[hours\] will be registered for each participant
Time frame: For the duration of postoperative hospital stay, an expected average of 72 hours
Vomiting episodes
The daily number of vomiting episodes will be registered for each participant
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Time frame: Participants will be followed for the duration of hospital stay, an expected average of 3 days
Continuous transcutaneous saturation
Continuous transcutaneous oxygen saturation (percentage), measured by Pulsox 300i (C) (Konica Minolta, Osaka, Japan)
Time frame: From surgery to postoperative day 3 at 12 pm
C-reactive protein from venous blood sample
Daily C-reactive protein measured in a venous blood sample.
Time frame: Preoperative and for the duration of hospital stay, an expected average of 3 days
Ear temperature
Ear temperature (celsius degree) measured daily at 9 and 15.
Time frame: Preoperative and for the duration of hospital stay, an expected average of 3 days
Detailed reason for not being discharged if criteria are otherwise fulfilled
The reason(s) for participants not being discharged if discharge criteria are otherwise fulfilled.
Time frame: From surgery and for the duration of hospital stay, an expected average of 3 days
Daily wound drain production
Daily registration of the fluid volume \[milliliters\] in the wound drains postoperative.
Time frame: From surgery and for the duration of hospital stay, an expected average of 3 days