A randomized controlled trial of subcutaneous closed-suction Blake drains for the prevention of incisional surgical site infection after colorectal surgery

Watanabe, Jun; Ota, Mitsuyoshi; Kawamoto, Makoto; Yago, Akikazu; Suwa, Yusuke; Suwa, Hirokazu; Momiyama, Masashi; Ishibe, Atsushi; Watanabe, Kazuteru; Masui, Hidenobu; Nagahori, Kaoru

doi:10.1007/s00384-016-2687-2

Cited by 26 publications

(20 citation statements)

References 29 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Logistic regression analysis demonstrated that thickness of subcutaneous fat > 3.0 cm, forced expiratory volume in 1 s as percent of forced vital capacity (FEV1.0%) > 70%, and subcutaneous drain were independent predictors of postoperative incisional SSIs (P = 0.008, P = 0.004, and P = 0.017, respectively). The authors affirmed that a subcutaneous Blake drain is beneficial for preventing incisional SSIs in patients undergoing colorectal surgery [76].…”

Section: Resultsmentioning

confidence: 94%

See 1 more Smart Citation

Intraoperative surgical site infection control and prevention: a position paper and future addendum to WSES intra-abdominal infections guidelines

Simone¹,

Sartelli

Coccolini

et al. 2020

World J Emerg Surg

View full text Add to dashboard Cite

Background: Surgical site infections (SSI) represent a considerable burden for healthcare systems. They are largely preventable and multiple interventions have been proposed over past years in an attempt to prevent SSI. We aim to provide a position paper on Operative Room (OR) prevention of SSI in patients presenting with intraabdominal infection to be considered a future addendum to the well-known World Society of Emergency Surgery (WSES) Guidelines on the management of intra-abdominal infections. Methods: The literature was searched for focused publications on SSI until March 2019. Critical analysis and grading of the literature has been performed by a working group of experts; the literature review and the statements were evaluated by a Steering Committee of the WSES.Results: Wound protectors and antibacterial sutures seem to have effective roles to prevent SSI in intra-abdominal infections. The application of negative-pressure wound therapy in preventing SSI can be useful in reducing postoperative wound complications. It is important to pursue normothermia with the available resources in the intraoperative period to decrease SSI rate. The optimal knowledge of the pharmacokinetic/pharmacodynamic characteristics of antibiotics helps to decide when additional intraoperative antibiotic doses should be administered in patients with intra-abdominal infections undergoing emergency surgery to prevent SSI.Conclusions: The current position paper offers an extensive overview of the available evidence regarding surgical site infection control and prevention in patients having intra-abdominal infections.

show abstract

Section: Resultsmentioning

confidence: 94%

“…Recently, Watanabe et al [76] decided to evaluate the effects of subcutaneous closed-suction Blake drain for preventing SSIs after colorectal surgery performing an RCT, enrolling 240 patients. The incidence of incisional SSI was 8.7% in the overall patients.…”

Section: Resultsmentioning

confidence: 99%

Intraoperative surgical site infection control and prevention: a position paper and future addendum to WSES intra-abdominal infections guidelines

Simone¹,

Sartelli

Coccolini

et al. 2020

World J Emerg Surg

View full text Add to dashboard Cite

show abstract

“…In general, some factors such as smoking, obesity, and diabetes mellitus are reported as risk factors for SSI occurrence [9,19] but in elective surgery, countermeasures such as smoking cessation or weight reduction may also be considered; however, it is difficult in emergency surgery. In colorectal surgery, the left-side colon and stoma creation are also mentioned [17,20]; however, taking measures specifically for each disease is difficult.…”

Section: Discussionmentioning

confidence: 99%

“…In cases with subcutaneous fat tissue of > 20 mm in colorectal emergency surgery, SSI has been improved from 39 to 14% by placing a subcutaneous drain. In addition, Watanabe et al [9] reported that subcutaneous drainage effectively prevented incisional SSI in their RCT on 200 cases of colorectal surgery. Conversely, Baier et al [22] reported that subcutaneous drainage has no effect on incisional SSI in their RCT with the same number of cases.…”

Section: Discussionmentioning

confidence: 99%

“…Measures such as wound protectors, intraperitoneal irrigation, and subcutaneous drain during wound closure have been reported to prevent incisional SSI [5][6][7][8][9]; however, evidences on operations with severe contamination such as colorectal perforation are lacking although less contamination can be expected in elective operations. Delayed primary closure (DPC) is adapted as a wound closure method for patients with severely contaminated peritonitis.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Postoperative Shock as Independent Factor for Incisional Surgical Site Infection in Left-Side Colorectal Perforation

Asano

Fukano

Shinozuka

2020

SN Compr. Clin. Med.

View full text Add to dashboard Cite

The incidence of incisional surgical site infection (SSI) in patients with colorectal perforation is reported to be approximately 40%. Although these subcutaneous drains and wound protector are performed using a wound closure method aimed to prevent incisional SSI, the evidence for colorectal perforation is poor. Although delayed primary closure (DPC) is reported to be an effective method to maintain open wounds, its management is time-consuming and cannot be performed in all cases. Therefore, the closure method should be carefully selected based on the risk of SSI. This study aimed to evaluate the risk factors of incisional SSI in left-side colorectal perforation with stoma creation. A total of 130 patients who underwent emergency surgery for left-side colorectal perforation with stoma creation between 2007 and 2017 were retrospectively investigated. Univariable and multivariable analyses were used to identify risk factors for incisional SSI. The total number of patients with incisional SSI was 58 (45%). In the univariate analysis, postoperative shock, postoperative ventilator support, and base excess (< − 2.0) were correlated with higher risk of incisional SSI. Multivariate analysis showed that postoperative shock was an independent risk factor for incisional SSI (odds ratio, 2.60; 95% confidence interval, 1.06-6.37). Postoperative shock is the risk factor of incisional SSI in left-side colorectal perforation with stoma. DPC should be considered in case of colorectal perforation combined with shock.

show abstract

Prophylactic subcutaneous drainage reduces post-operative incisional infections in colorectal surgeries: a meta-analysis of randomized controlled trials

Pang

Sun

et al. 2021

Int J Colorectal Dis

View full text Add to dashboard Cite

A randomized controlled trial of subcutaneous closed-suction Blake drains for the prevention of incisional surgical site infection after colorectal surgery

Abstract: The results of our RCT suggest that a subcutaneous Blake drain is beneficial for preventing incisional SSIs in patients undergoing colorectal surgery.

Cited by 26 publications

References 29 publications

Intraoperative surgical site infection control and prevention: a position paper and future addendum to WSES intra-abdominal infections guidelines

Intraoperative surgical site infection control and prevention: a position paper and future addendum to WSES intra-abdominal infections guidelines

Postoperative Shock as Independent Factor for Incisional Surgical Site Infection in Left-Side Colorectal Perforation

Prophylactic subcutaneous drainage reduces post-operative incisional infections in colorectal surgeries: a meta-analysis of randomized controlled trials

Contact Info

Product

Resources

About