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伤口边缘保护器预防结直肠疾病开放手术后手术部位感染的有效性:一项有两个平行研究组的前瞻性队列研究

Effectiveness of Wound-Edge Protectors for Preventing Surgical Site Infections after Open Surgery for Colorectal Disease: A Prospective Cohort Study with Two Parallel Study Groups.

作者信息

Kobayashi Hirotoshi, Uetake Hiroyuki, Yasuno Masamichi, Sugihara Kenichi

机构信息

Department of Surgery, Tokyo Metropolitan Hiroo Hospital, Tokyo,

Department of Surgical Oncology, Graduate School, Tokyo Medical and Dental University, Tokyo, Japan.

出版信息

Dig Surg. 2019;36(1):83-88. doi: 10.1159/000488214. Epub 2018 Apr 26.

Abstract

BACKGROUND

Standard procedures to reduce the surgical site infection (SSI) rate after colorectal surgery have not been established. A prospective cohort study with 2 parallel study groups was performed to clarify the SSI rate after open surgery with and without a wound-edge protector (WEP) for colorectal disease.

METHODS

A total of 102 patients who underwent elective open surgery for colorectal disease between October 2012 and August 2014 were randomly assigned to a WEP group and a WEP (-) group. The primary endpoint was the SSI rate in both groups.

RESULTS

Fifty-one patients were assigned to the WEP group and 51 to the WEP (-) group. Two patients were excluded from this study. The rate of SSI with and without a WEP was 16 and 36% respectively (p = 0.021). Older age (p = 0.0073) and no WEP (p = 0.021) were risk factors for SSI after open surgery for colorectal diseases on univariate analysis. On multivariate analysis, both older age (p = 0.016) and no WEP (p = 0.012) were independent risk factors for SSI.

CONCLUSION

The present randomized, phase II trial found an SSI rate of 16% with use of a WEP. The SSI rate was lower in the WEP group than in the WEP (-) group. A WEP may reduce the SSI rate after open surgery for colorectal disease in Japanese patients.

摘要

背景

结直肠手术后降低手术部位感染(SSI)率的标准程序尚未确立。进行了一项有2个平行研究组的前瞻性队列研究,以阐明结直肠疾病开放手术使用和不使用伤口边缘保护器(WEP)后的SSI率。

方法

2012年10月至2014年8月期间接受择期结直肠疾病开放手术的102例患者被随机分为WEP组和WEP(-)组。主要终点是两组的SSI率。

结果

51例患者被分配到WEP组,51例被分配到WEP(-)组。2例患者被排除在本研究之外。使用和不使用WEP的SSI率分别为16%和36%(p = 0.021)。单因素分析显示,年龄较大(p = 0.0073)和未使用WEP(p = 0.021)是结直肠疾病开放手术后SSI的危险因素。多因素分析显示,年龄较大(p = 0.016)和未使用WEP(p = 0.012)均是SSI的独立危险因素。

结论

本项随机II期试验发现,使用WEP时SSI率为16%。WEP组的SSI率低于WEP(-)组。在日本患者中,WEP可能会降低结直肠疾病开放手术后的SSI率。

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