Early outcomes of an enhanced recovery protocol for open repair of ventral hernia

Background: Enhanced recovery after surgery (ERAS) protocols are evidence-based quality improvement pathways reported to be associated with improved patient outcomes. The purpose of this study was to compare short-term outcomes for open ventral hernia repair (VHR) before and after implementation of an ERAS protocol. Methods: After obtaining IRB approval, surgical databases were searched for VHR cases for two years prior and eleven months after protocol implementation for retrospective review. Groups were compared on perioperative characteristics and clinical outcomes using chi-square, Fisher’s exact, or Mann–Whitney U test, as appropriate. Results: One hundred and seventy-one patients underwent VHR (46 patients with ERAS protocol in place and 125 historic controls). Age, gender, ASA Class, comorbidities, and smoking status were similar between the two groups. Body mass index was lower among ERAS patients (p =.038). ERAS patients had earlier return of bowel function (median 3 vs. 4 days) (p =.003) and decreased incidence of superficial surgical site infection (SSI) (7 vs. 25%) (p =.008) than controls. Conclusion: An ERAS protocol for VHR demonstrated improved patient outcomes. A system-wide culture focused on enhanced recovery is needed to ensure improved patient outcomes.