Papaconstantinou Harry T, Birnbaum Elisa H, Ricciardi Rocco, Margolin David A, Moesinger Robert C, Lichliter Warren E, Thomas J Scott, Bergamaschi Roberto
1 Department of Surgery, Baylor Scott & White Healthcare , Temple, Texas.
2 Department of Surgery, Section of Colon and Rectal Surgery, Washington University School of Medicine , St. Louis, Missouri.
Surg Infect (Larchmt). 2019 Jan;20(1):35-38. doi: 10.1089/sur.2018.112. Epub 2018 Sep 20.
Surgical site infection (SSI) remains a persistent and morbid problem in colorectal surgery. A novel surgical device that combines barrier surgical wound protection and continuous surgical wound irrigation was evaluated in a cohort of elective colorectal surgery patients. A retrospective analysis was performed comparing rates of SSI observed in a prospective cohort study with the predicted rate of SSI using the American College of Surgeons (ACS) National Surgical Quality Improvement Program (NSQIP) Risk Calculator.
A prospective multi-center study of colectomy patients was conducted using a study device for surgical site retraction and protection, as well as irrigation of the incision. Patients were followed for 30 days after the surgical procedure to assess for SSI. After completion of the study, patients' characteristics were inserted into the ACS-NSQIP Risk Calculator to determine the predicted rate of SSI for the given patient population and compared with the observed rate in the study.
A total of 108 subjects were enrolled in the study. The observed rate of SSI in the prospective study using the novel device was 3.7% (4/108). The predicted rate of SSI in the same patient population utilizing the ACS-NSQIP Risk Calculator was estimated to be 9.5%. This demonstrated a 61% difference (3.7% vs. 9.5%, p = 0.04) in SSI from the NSQIP predicted rate with the use of the irrigating surgical wound protection and retraction device.
These data suggest the use of a novel surgical wound protection device seems to reduce the rate of SSIs in colorectal surgery.
手术部位感染（SSI）仍是结直肠手术中持续存在且引发病态的问题。在一组择期结直肠手术患者中，对一种结合了手术伤口屏障保护和持续手术伤口冲洗功能的新型手术器械进行了评估。通过回顾性分析，比较了在前瞻性队列研究中观察到的SSI发生率与使用美国外科医师学会（ACS）国家外科质量改进计划（NSQIP）风险计算器预测的SSI发生率。
对结肠切除术患者进行了一项前瞻性多中心研究，使用一种用于手术部位牵开和保护以及切口冲洗的研究器械。术后对患者进行30天随访以评估SSI情况。研究结束后，将患者特征输入ACS-NSQIP风险计算器，以确定给定患者群体的SSI预测发生率，并与研究中观察到的发生率进行比较。
共有108名受试者纳入该研究。在前瞻性研究中，使用该新型器械观察到的SSI发生率为3.7%（4/108）。使用ACS-NSQIP风险计算器对同一患者群体估计的SSI预测发生率为9.5%。这表明，使用手术伤口冲洗保护和牵开器械后，SSI发生率与NSQIP预测发生率存在61%的差异（3.7%对9.5%，p = 0.04）。
这些数据表明，使用新型手术伤口保护器械似乎可降低结直肠手术中的SSI发生率。
