Capolupo Gabriella Teresa, Lauricella Sara, Mascianà Gianluca, Caricato Chiara, Angeletti Silvia, Ciccozzi Massimo, Coppola Roberto, Caricato Marco
Department of Geriatric Surgery Unit, Campus Bio-Medico of Rome University, Rome, Italy.
Unit of Clinical Laboratory Science, Department of Medicine, Campus Bio-Medico of Rome University, Rome, Italy.
JSLS. 2019 Oct-Dec;23(4). doi: 10.4293/JSLS.2019.00048.
Surgical-site infections (SSIs) remain a serious complication of colorectal surgery, causing a significant financial burden to the health care system. The aim of this study is to investigate whether the use of an O-ring retractor can be effective in preventing the incidence of wound infections after elective laparoscopic colorectal surgery.
A retrospective case-control study from January 2014 to June 2018 was performed. Data were analyzed from a retrospective colorectal database. SSI was defined according to criteria published by the European Centre for Disease Prevention and Control and analyzed as a primary outcome.
Three hundred twelve consecutive patients (n = 312) were enrolled in our study. Among them, 158 patients (Group A) in which an O-ring retractor device was used during surgery was compared with a control group of 154 patients (Group B) in which an O-ring retractor device was not used. Primary outcome was to determine SSIs rates among the 2 groups. No statistically differences were observed with regard to baseline characteristics between both groups. A total of 9 patients (5.69%) and 24 (15.58%) with SSIs were identified in Group A and B, respectively, and the difference was statistically significant (OR, 0.32; 95% CI, 0.14-0.72; = .0045). The median postoperative hospital stay length was 6.7 days in group A and 7.6 days in group B ( ≤ .05).
SSIs infections rates were significantly higher in patients in which an O-ring retractor device was not used. This study suggests that the use of a wound protector device can be considered for routine use in elective colorectal surgery.
手术部位感染(SSIs)仍然是结直肠手术的一种严重并发症,给医疗保健系统带来巨大经济负担。本研究的目的是调查使用O形环牵开器是否能有效预防择期腹腔镜结直肠手术后伤口感染的发生率。
进行了一项2014年1月至2018年6月的回顾性病例对照研究。数据来自一个回顾性结直肠数据库。根据欧洲疾病预防控制中心公布的标准定义手术部位感染,并将其作为主要结局进行分析。
我们的研究纳入了312例连续患者。其中,158例患者(A组)在手术中使用了O形环牵开器装置,并与154例未使用O形环牵开器装置的对照组患者(B组)进行比较。主要结局是确定两组中的手术部位感染率。两组之间在基线特征方面未观察到统计学差异。A组和B组分别有9例(5.69%)和24例(15.58%)发生手术部位感染,差异具有统计学意义(OR,0.32;95%CI,0.14 - 0.72;P = 0.0045)。A组术后住院时间中位数为6.7天,B组为7.6天(P≤0.05)。
未使用O形环牵开器装置的患者手术部位感染率显著更高。本研究表明,伤口保护装置可考虑在择期结直肠手术中常规使用。