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01-11-2017 | Original Scientific Report

The Benefits of a Wound Protector in Preventing Incisional Surgical Site Infection in Elective Open Digestive Surgery: A Large-Scale Cohort Study

Authors: Keita Itatsu, Yukihiro Yokoyama, Gen Sugawara, Satoaki Kamiya, Masaki Terasaki, Atsushi Morioka, Shinsuke Iyomasa, Kazuhisa Shirai, Masahiko Ando, Masato Nagino

Published in: World Journal of Surgery | Issue 11/2017

Abstract

Background

The objective of this study was to evaluate the benefits of wound protectors (WPs) in preventing incisional surgical site infection (I-SSI) in open elective digestive surgery using data from a large-scale, multi-institutional cohort study.

Methods

Patients who had elective digestive surgery for malignant neoplasms between November 2009 and February 2011 were included. The protective value of WPs against I-SSI was evaluated.

Results

A total of 3201 patients were analyzed. A WP was used in 1022 patients (32%). The incident rate of I-SSI (not including organ/space SSI) was 9%. In the univariate and the multivariate analyses for perioperative risk factors for I-SSI, the use of WP was an independent favorable factor that reduced the incidence of I-SSI (odds ratio 0.73, 95% confidence interval 0.55–0.98. P = 0.038). The subgroup forest plot analyses revealed that WP reduced the risk of I-SSI only in patients aged 74 years or younger, males, non-obese patients (body mass index <25 kg/m²), patients with an American Society of Anesthesiologists score of 1/2, patients with a previous history of laparotomy, non-smokers, and patients who underwent colon and rectum operations. In patients who underwent colorectal surgery, the postoperative hospital stay was significantly shorter in patients with WP than those without WP (median 13 vs. 15 days, P = 0.040). In terms of the depth of SSI, WP only prevented superficial I-SSI and did not reduce the incidence of deep I-SSI.

Conclusions

WP is a useful device for preventing superficial I-SSI in open elective digestive surgery.

Trial registration number

UMIN000004723.

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Title: The Benefits of a Wound Protector in Preventing Incisional Surgical Site Infection in Elective Open Digestive Surgery: A Large-Scale Cohort Study
Authors: Keita Itatsu
Yukihiro Yokoyama
Gen Sugawara
Satoaki Kamiya
Masaki Terasaki
Atsushi Morioka
Shinsuke Iyomasa
Kazuhisa Shirai
Masahiko Ando
Masato Nagino
Publication date: 01-11-2017
Publisher: Springer International Publishing
Published in: World Journal of Surgery / Issue 11/2017
Print ISSN: 0364-2313
Electronic ISSN: 1432-2323
DOI: https://doi.org/10.1007/s00268-017-4082-8

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

The Benefits of a Wound Protector in Preventing Incisional Surgical Site Infection in Elective Open Digestive Surgery: A Large-Scale Cohort Study

Abstract

Background

Methods

Results

Conclusions

Trial registration number

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

Trial registration number

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