A Wound Protector Shields Incision Sites from Bacterial Invasion

Horiuchi, Tetsuya; Tanishima, Hiroyuki; Tamagawa, Kouji; Sakaguchi, Shoji; Shono, Yoshiharu; Tsubakihara, Hideaki; Tabuse, Katsuyoshi; Kinoshita, Yukiyasu

doi:10.1089/sur.2009.072

Cited by 50 publications

(35 citation statements)

References 8 publications

(8 reference statements)

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“…It also supports the statement that various measures for the control of the superficial SSI can be highly effect ive. 32 Like other authors, 33 we observed seasonal variations in the frequency of fungi, with lower levels in autumn and winter; however, the most common fungus in our study was Penicillum rather than the previously reported Aspergillus. With regard to the number of CFU found in our study, these were quite low compared with the levels published elsewhere 34 in studies that observed the lowest levels of CFU in operating rooms with 12 ± 14 CFU/m 3 .…”

Section: Environmental Biosafety Factorssupporting

confidence: 76%

Analyzing the risk factors influencing surgical site infections: the site of environmental factors

Martínez

Martín-Moreno

et al. 2017

CJS

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Background: Addressing surgical site infection (SSI) is accomplished, in part, through studies that attempt to clarify the nature of many essential factors in the control of SSI. We sought to examine the link between multiple risk factors, including environmental factors, and SSI for prevention management. Methods:We conducted a longitudinal prospective study to identify SSIs in all patients who underwent interventions in 2014 in 8 selected hospitals on the Mediterranean coast of Spain. Risk factors related to the operating theatre included level of fungi and bacterial contamination, temperature and humidity, air renewal and differential air pressure. Patient-related variables included age, sex, comorbidity, nutrition level and transfusion. Other factors were antibiotic prophylaxis, electric versus manual shaving, American Society of Anaesthesiologists physical status classification, type of intervention, duration of the intervention and preoperative stay.Results: Superficial SSI was most often associated with environmental factors, such as environmental contamination by fungi (from 2 colony-forming units) and bacteria as well as surface contamination. When there was no contamination in the operating room, no SSI was detected. Factors that determined deep and organ/space SSI were more often associated with patient characteristics (age, sex, transfusion, nasogastric feeding and nutrition, as measured by the level of albumin in the blood), type of intervention and preoperative stay. Antibiotic prophylaxis and shaving with electric razor were protective factors for both types of infection, whereas the duration of the intervention and the classification of the intervention as "dirty" were shared risk factors. Conclusion:Our results suggest the importance of environmental and surface contamination control to prevent SSI.Contexte : La lutte contre les infections du site opératoire (ISO) passe entre autres par des études visant à clarifier la nature de nombreux facteurs essentiels de contrôle. Nous avons donc cherché à examiner le lien entre divers facteurs de risque, notamment de nature environnementale, et les ISO, dans une optique de prévention.

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Section: Environmental Biosafety Factorssupporting

confidence: 76%

Analyzing the risk factors influencing surgical site infections: the site of environmental factors

Martínez

Martín-Moreno

et al. 2017

CJS

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“…The use of the Alexis wound protector has been reported to protect surgical wounds from contamination by bacteria and, consequently, to prevent infection during gastrointestinal surgery. 9 Horiuchi et al 10 reported that the use of the Alexis retractor at incision sites during gastric and colorectal surgery significantly reduced the incidence of wound infections (superficial infections at the sites of surgical incisions) in a randomized controlled study. The same wound protector also significantly reduced the risk of wound complications in this study.…”

Section: Discussionmentioning

confidence: 99%

Use of an upper midline incision for living donor partial hepatectomy: A series of 143 consecutive cases

et al. 2011

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Over a period of 2 years, we used an upper midline incision (UMI) without laparoscopic assistance in 143 consecutive living donor partial hepatectomy (LDPH) procedures, regardless of the graft type or the donor age, sex, body mass index, or body shape. Here we report surgical recommendations based on our experience with the use of UMIs in this context. The celiac axis (CA) depth ratio (the depth-to-width ratio for the trunk at the CA) was measured to define the shape of the abdominal cavity. A questionnaire was used to assess satisfaction and cosmetic outcomes in this population of donors. One hundred forty-one of the grafts (98.6%) were right grafts or extended right grafts; there were no donor deaths. The mean time of the operation up to graft retrieval in 141 right side grafts was 3 hours 1 minute. All donors recovered fully and returned to their previous activities. Major complications occurred in 9 patients (6.4%) and included reoperation due to bleeding (4), the insertion of a percutaneous drain (4), and rhabdomyolysis (1). Male sex, a large graft (>900 kg), a fatty liver (large fatty changes 10%), and a deep truncal cavity (a CA depth ratio > 0.35) were significant risk factors for a long graft retrieval time. The use of a wound protector significantly reduced wound complications. The cosmetic outcomes were more satisfactory when a UMI preceded partial hepatectomy instead of a conventional J-shaped incision (P ¼ 0.01).In conclusion, a UMI without laparoscopic assistance can be safely used for LDPH, regardless of the graft type or the donor characteristics. However, the procedure after a UMI is more difficult in male donors with large fatty livers and deep truncal cavities. Accordingly, these features can be used as exclusion criteria for surgeons not accustomed to this modified procedure. Liver Transpl 17:969-975, 2011. V C 2011 AASLD.Received November 8, 2010; accepted March 31, 2011.A major concern for individuals who volunteer to be living donors of liver tissue is the length of the incision that will be made. There have been several attempts to reduce the length of these incisions. Several laparoscopy-assisted approaches have been reported; these have yielded good results, but the procedures have tended to be complex and expensive.

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“…The risk factors for SSI limited to laparoscopic colon resection have been reported to include increased BMI and a history of DM (11)(12)(13). Wound retractors can prevent infection after laparoscopic colorectal procedures, indicating that the methods and instruments used are important (14,15). In our department, the incidence of ANTICANCER RESEARCH 38: 513-517 (2018) 514 transumbilical wound SSI in LAC was 4.3% (15/348).…”

Section: Discussionmentioning

confidence: 83%

Evaluation of a Transumbilical Incision as an Approach for Organ Removal in Laparoscopy-assisted Colectomy

Tomioka

Murakami

Watanabe

et al. 2018

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Abstract. Aim: To investigate the risk factors of transumbilical incision for organ removal in laparoscopyassisted colectomy (LAC).In laparoscopic surgery, a transumbilical incision is often used for anastomosis and organ removal. In our Department, we have been performing transumbilical incisions to remove resected organs since shortly after the introduction of laparoscopic surgery. We vertically extend the umbilical wound corresponding to the size of the specimen and anastomose extracorporeally. We have already reported that surgical site infection (SSI) and hernia occurred at a significantly higher rate in colorectal resection than in gastric resection in laparoscopic surgery. Additionally, we showed that female sex and diabetes mellitus (DM) were independent risk factors in relation to hernia (1).The present study aimed to evaluate the complication rates and risk factors associated with transumbilical incisions in laparoscopy-assisted colectomy (LAC). Patients and MethodsThis study included a cohort of 417 consecutive patients who underwent LAC for colorectal cancer at

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A Wound Protector Shields Incision Sites from Bacterial Invasion

Abstract: These results suggest that the WP protects an incision site from bacterial invasion.

Cited by 50 publications

References 8 publications

Analyzing the risk factors influencing surgical site infections: the site of environmental factors

Analyzing the risk factors influencing surgical site infections: the site of environmental factors

Use of an upper midline incision for living donor partial hepatectomy: A series of 143 consecutive cases

Evaluation of a Transumbilical Incision as an Approach for Organ Removal in Laparoscopy-assisted Colectomy

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