Top

Published in:

01-12-2015 | ORIGINAL ARTICLE

Efficacy of skin closure with subcuticular sutures for preventing wound infection after resection of colorectal cancer: a propensity score–matched analysis

Authors: Yusuke Yamaoka, Masataka Ikeda, Masakazu Ikenaga, Naotsugu Haraguchi, Masakazu Miyake, Kazuyoshi Yamamoto, Tadafumi Asaoka, Kazuhiro Nishikawa, Atsushi Miyamoto, Michihiko Miyazaki, Motohiro Hirao, Shoji Nakamori, Mitsugu Sekimoto

Published in: Langenbeck's Archives of Surgery | Issue 8/2015

Abstract

Purpose

The purpose of this study was to examine the efficacy of skin closure with subcuticular sutures for the prevention of wound infection after colorectal cancer resection.

Methods

Medical records of 1008 patients with colorectal cancer who underwent resection between 2006 and 2013 were reviewed. Patients were divided into two groups based on skin closure method: the subcuticular suture group (n = 323) and the staple group (n = 685). The incidence of wound infection was compared with and without propensity score matching, and multivariate analysis was performed to identify risk factors for wound infection.

Results

The incidence of wound infection was 3.1 % (10/323) in the subcuticular suture group and 10.4 % (71/685) in the staple group. After propensity score matching, the incidence of wound infection was significantly lower in the subcuticular suture group (4.6 %, 9/197) than in the staple group (12.2 %, 24/197) (p = 0.004). In the propensity score–matched cohort, multivariate analysis identified advanced age (odds ratio [OR], 1.07; 95 % confidence interval [CI], 1.03–1.12), higher preoperative body mass index (OR, 1.19; 95 % CI, 1.07–1.33), lower preoperative serum albumin (OR, 0.45; 95 % CI, 0.22–0.91), open surgery (OR, 3.28; 95 % CI, 1.38–8.49), and skin closure with staples (OR, 3.21; 95 % CI, 1.43–7.81) as independent risk factors for wound infection.

Conclusions

Our results suggest that subcuticular suturing could be beneficial after colorectal cancer surgery.

Smith RL, Bohl JK, McElearney ST, Friel CM, Barclay MM, Sawyer RG, Foley EF (2004) Wound infection after elective colorectal resection. Ann Surg 239:599–605PubMedCentralCrossRefPubMed

Serra-Aracil X, García-Domingo MI, Parés D, Espin-Basany E, Biondo S, Guirao X et al (2011) Surgical site infection in elective operations for colorectal cancer after the application of preventive measures. Arch Surg 146:606–612CrossRefPubMed

Sørensen LT, Hemmingsen UB, Kirkeby LT, Kallehave F, Jørgensen LN (2005) Smoking is a risk factor for incisional hernia. Arch Surg 140:119–123CrossRefPubMed

Shetty AA, Kumar VS, Morgan-Hough C, Georgeu GA, James KD, Nicholl JE (2004) Comparing wound complication rates following closure of hip wounds with metallic skin staples or subcuticular vicryl suture: a prospective randomised trial. J Orthop Surg (Hong Kong) 12:191–193

Angelini GD, Butchart EG, Armistead SH, Breckenridge IM (1984) Comparative study of leg wound skin closure in coronary artery bypass graft operations. Thorax 39:942–945PubMedCentralCrossRefPubMed

Chughtai T, Chen LQ, Salasidis G, Nguyen D, Tchervenkov C, Morin JF (2000) Clips versus suture technique: is there a difference? Can J Cardiol 16:1403–1407PubMed

Basha SL, Rochon ML, Quiñones JN, Coassolo KM, Rust OA, Smulian JC (2010) Randomized controlled trial of wound complication rates of subcuticular suture vs staples for skin closure at cesarean delivery. Am J Obstet Gynecol 203:285.e1-8CrossRefPubMed

Figueroa D, Jauk VC, Szychowski JM, Garner R, Biggio JR, Andrews WW et al (2013) Surgical staples compared with subcuticular suture for skin closure after cesarean delivery: a randomized controlled trial. Obstet Gynecol 121:33–38CrossRefPubMed

Tsujinaka T, Yamamoto K, Fujita J, Endo S, Kawada J, Nakahira S et al (2013) Clinical Study Group of Osaka University on Section of Risk Management. Subcuticular sutures versus staples for skin closure after open gastrointestinal surgery: a phase 3, multicentre, open-label, randomised controlled trial. Lancet 382:1105–1112CrossRefPubMed

10.

Kobayashi S, Ito M, Yamamoto S, Kinugasa Y, Kotake M, Saida Y et al (2015) Randomized clinical trial of skin closure by subcuticular suture or skin stapling after elective colorectal cancer surgery. Br J Surg 102:495–500CrossRefPubMed

11.

Mangram AJ, Horan TC, Pearson ML, Silver LC, Jarvis WR (1999) Guideline for prevention of surgical site infection, 1999. Hospital Infection Control Practices Advisory Committee. Infect Control Hosp Epidemiol 20:250–278CrossRefPubMed

12.

Tang R, Chen HH, Wang YL, Changchien CR, Chen JS, Hsu KC et al (2001) Risk factors for surgical site infection after elective resection of the colon and rectum: a single-center prospective study of 2,809 consecutive patients. Ann Surg 234:181–189PubMedCentralCrossRefPubMed

13.

Biondo S, Kreisler E, Fraccalvieri D, Basany EE, Codina-Cazador A, Ortiz H (2012) Risk factors for surgical site infection after elective resection for rectal cancer. A multivariate analysis on 2131 patients. Colorectal Dis 14:e95–e102CrossRefPubMed

14.

Silber JH, Rosenbaum PR, Trudeau ME, Even-Shoshan O, Chen W, Zhang X, Mosher RE (2001) Multivariate matching and bias reduction in the surgical outcomes study. Med Care 39:1048–1064CrossRefPubMed

15.

D’Agostino RB Jr (1998) Propensity score methods for bias reduction in the comparison of a treatment to a non-randomized control group. Stat Med 17:2265–2281CrossRefPubMed

16.

Zografos GC, Martis K, Morris DL (1992) Laser Doppler flowmetry in evaluation of cutaneous wound blood flow using various suturing techniques. Ann Surg 215:266–268PubMedCentralCrossRefPubMed

17.

Retzlaff K, Agarwal S, Song DH, Dorafshar AH (2010) The four-step subcuticular suture technique. Plast Reconstr Surg 126:50e-1CrossRef

18.

Robinson JK, Anderson ER (2005) Skin structure and surgical anatomy. In: Robinson JK, Hanke CW, Sengelmann RD, Siegel DM (eds) Surgery of the skin. Elsevier Mosby, Philadelphia, pp 3–23CrossRef

19.

Singer AJ, Clark RA (1999) Cutaneous wound healing. N Engl J Med 341:738–746CrossRefPubMed

20.

Nakamura T, Mitomi H, Ihara A, Onozato W, Sato T, Ozawa H et al (2008) Risk factors for wound infection after surgery for colorectal cancer. World J Surg 32:1138–1141CrossRefPubMed

21.

Degrate L, Garancini M, Misani M, Poli S, Nobili C, Romano F (2011) Right colon, left colon, and rectal surgeries are not similar for surgical site infection development. Analysis of 277 elective and urgent colorectal resections. Int J Colorectal Dis 26:61–69CrossRefPubMed

Title: Efficacy of skin closure with subcuticular sutures for preventing wound infection after resection of colorectal cancer: a propensity score–matched analysis
Authors: Yusuke Yamaoka
Masataka Ikeda
Masakazu Ikenaga
Naotsugu Haraguchi
Masakazu Miyake
Kazuyoshi Yamamoto
Tadafumi Asaoka
Kazuhiro Nishikawa
Atsushi Miyamoto
Michihiko Miyazaki
Motohiro Hirao
Shoji Nakamori
Mitsugu Sekimoto
Publication date: 01-12-2015
Publisher: Springer Berlin Heidelberg
Published in: Langenbeck's Archives of Surgery / Issue 8/2015
Print ISSN: 1435-2443
Electronic ISSN: 1435-2451
DOI: https://doi.org/10.1007/s00423-015-1347-2

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Efficacy of skin closure with subcuticular sutures for preventing wound infection after resection of colorectal cancer: a propensity score–matched analysis

Abstract

Purpose

Methods

Results

Conclusions

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 8/2015

Completion pancreatectomy for recurrent pancreatic cancer in the remnant pancreas: report of six cases and a review of the literature

Sporadic multiple parathyroid gland disease—a consensus report of the European Society of Endocrine Surgeons (ESES)

Transanal total mesorectal excision for rectal cancer: a single center experience and systematic review of the literature

Hereditary hyperparathyroidism—a consensus report of the European Society of Endocrine Surgeons (ESES)

Effect of perioperative dexamethasone on subjective voice quality after thyroidectomy: a meta-analysis and systematic review

Successful minimally invasive surgery for primary hyperparathyroidism: influence of preoperative imaging and intraoperative parathyroid hormone levels