Risk Factors for Surgical Site Infection after Laparoscopic Surgery for Colon Cancer

Nakamura, Takatoshi; Sato, Takeo; Takayama, Yoko; Naito, Masanori; Yamanashi, Takahiro; Miura, Hirohisa; Tsutsui, Atsuko; Yamashita, Keishi; Watanabe, Masahiko

doi:10.1089/sur.2015.205

Cited by 22 publications

(21 citation statements)

References 17 publications

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“…). After final review, data from 34 distinct studies were included in the final assessment, yielding a total of 38 data points (2 studies had multiple SSIs per surgical wound type). Surgical wound types in the included study list are shown in Table S2 (supporting information).…”

Section: Resultsmentioning

confidence: 99%

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Meta-analysis of the potential economic impact following introduction of absorbable antimicrobial sutures

Leaper

Edmiston

Holy

2017

British Journal of Surgery

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Background: Despite several randomized trials, systematic reviews and meta-analyses that have demonstrated the effectiveness of antimicrobial (triclosan-coated or -impregnated) sutures (TCS), the clinical and economic impact of using these sutures compared with conventional non-antimicrobial-coated absorbable sutures (NCS) remains poorly documented.Methods: An independent systematic review and meta-analysis of all published evidence from January 2005 to September 2016 comparing TCS with NCS was conducted. Surgical-site infection (SSI) was the primary outcome. The results of the meta-analysis were used in a decision-tree deterministic and stochastic cost model, using the National Health Service (NHS England)-based cost of inpatient admissions for infections and differential costs of TCS versus NCS.Results: Thirty-four studies were included in the final assessment from an initial 163 identified citations; 20 of 34 studies were randomized, and 17 of 34 reported blinding of physicians and assessors. Using a random-effects model, the odds ratio for SSI in the TCS compared with NCS control groups was statistically significant (odds ratio 0⋅61, 95 per cent c.i. 0⋅52 to 0⋅73; P < 0⋅001). There was significant heterogeneity (I 2 = 49 per cent). Using random-effects event estimates of SSI for TCS and NCS for each individual wound type, the mean savings per surgical procedure from using antimicrobial sutures were significant: £91⋅25 (90 per cent c.i. 49⋅62 to 142⋅76) (€105⋅09 (57⋅15 to 164⋅41); exchange rate 15 November 2016) across all wound types. Conclusion:The reviewed literature suggested that antimicrobial sutures may result in significant savings across various surgical wound types.

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Section: Resultsmentioning

confidence: 99%

“…Rozzelle et al 47 Cerebrospinal fluid shunt surgery Yamashita et al 56 Colorectal surgery Nakamura et al 42 Colonic surgery…”

Section: Random-effects Modelmentioning

confidence: 99%

Meta-analysis of the potential economic impact following introduction of absorbable antimicrobial sutures

Leaper

Edmiston

Holy

2017

British Journal of Surgery

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“…17 According to the various reported studies, significant differences were found in the SSI rates when different suture materials were used. 9,20 In the early 1970s, with the development of the synthetic absorbable polymer, polyglycolic acid, the new era of absorbable polymeric sutures was started which got extraordinary commercial success. 19 Now a day, absorbable sutures have become a treatment of choice over non-absorbable sutures.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of safety and efficacy of polyglactin 910 suture in surgical incision closure: clinical study protocol for a randomized controlled trial

Dixit

Nadkarni

Shah³

et al. 2018

Int J Clin Trials

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Background: Surgical site infection (SSI) occurs in a considerable portion of patients after closure of surgical incision. The newer synthetic absorbable sutures consistently display proven advantages for wound healing over naturally derived suture. The study is planned to evaluate the safety and efficacy of MITSU™ Polyglactin 910 Suture with Coated Vicryl® Polyglactin 910 Suture in a closure of surgical incision. Methods: This is a prospective, multicentric, post-marketing, randomized, controlled, single-blinded, comparative study in a closure of surgical incision where general soft tissue approximation and/or ligation is required during an elective surgery. Patients are randomized to 1:1 ratio in the test (MITSU Polyglactin 910 Suture) and reference (Coated Vicryl Polyglactin 910 Suture) groups. Patients are monitored for safety and efficacy outcomes, viz. the rate of SSI, hospital length of stay, overall wound dehiscence and any adverse events/serious adverse events at post-procedural, 14 days, 30 days and 6 months of surgery. The rate of SSI for each group will be analyzed using one sided T-test. The effect of type of suture on SSI and overall wound dehiscence will be evaluated with chi-square test. Length of stay in hospital will be evaluated with student’s t-test.Conclusions: The study has been designed to compare the safety and efficacy of MITSU Polyglactin 910 Suture versus Coated Vicryl Polyglactin 910 Suture in a closure of surgical incision. Trial registration: The trial protocol has been registered with the clinical trial registry of India (CTRI/2017/01/007717; registered on 17/01/2017).

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“…Many papers have reported different preoperative, intraoperative, and postoperative risk factors for SSI in abdominal surgery [6][7][8], such as perioperative transfusion, cirrhosis, or anastomosis of the bowel. On the other hand, numerous studies have reported diabetic patients to be subject to postoperative infectious diseases including SSI [9][10][11]. Martin et al analyzed the association between diabetes and the risk of SSI in their large systematic review and meta-analysis and reported the overall effect size for the association between diabetes and SSI as odds ratio (OR) 1.53 [9].…”

Section: Introductionmentioning

confidence: 99%

Correlation Between Postoperative Hyperglycemia and the Occurrence of Surgical Site Infections After Surgery for Gastroenterological Malignancy: A Retrospective Analysis

Yamamoto

Ueda

Yoshitomi

et al. 2022

Preprint

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Background: Surgical site infection (SSI) is one of the most important complications after surgery for gastroenterological malignancy in that it leads to prolonged postoperative hospital stay and increased inpatient cost. Especially in case for malignancy, SSI sometimes delays the initiation of postoperative treatments including adjuvant chemotherapy and that can negatively affect prognosis.Methods: Patients with gastroenterological malignancy who underwent surgery in our institution were retrospectively reviewed and categorized according to the occurrence of incisional SSI; SSI group and no SSI group. The clinicopathological characteristics between two groups were compared, i.e. age, sex, body mass index, location of malignancy, results of postoperative blood examination, operation time, and amount of blood loss. Then, the same analysis was performed in the subpopulation that included colorectal cancer patients.Results: The 528 patients enrolled in the present study consisted of 330 males and 198 females of mean age 68 ± 11 years at the time of their operation. The numbers of patients with diseases of the esophagus, stomach, small intestine, colon and rectum, liver, gallbladder, and pancreas were 25, 150, 7, 255, 51, 5, and 35, respectively. Open surgery was performed in 303 patients and laparoscopic surgery in 225. Incisional SSI occurred in 46 patients (8.7%). Univariate analysis showed that postoperative hyperglycemia (serum glucose level ≥139 mg/dL within 24 h of operation) was the sole significant risk factor for incisional SSI (p=0.026). Multivariate analysis showed that postoperative hyperglycemia was an independent risk factor for incisional SSI (odds ratio 1.89, 95% confidence interval 1.009–3.614). In a subgroup analysis of patients who underwent colorectal surgery, the SSI occurred in 27 patients (10.5%). It also showed that postoperative hyperglycemia was a significant risk factor for incisional SSI (p=0.033), in addition to open surgery (p=0.024).Conclusions: Postoperative hyperglycemia was the independent risk factor for incisional SSI after surgery for gastroenterological malignancy. Prevention of postoperative hyperglycemia is important in achieving a decrease in the rate of incisional SSI.

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Risk Factors for Surgical Site Infection after Laparoscopic Surgery for Colon Cancer

Abstract: To prevent SSI after laparoscopic surgery for colon cancer, triclosan-coated PDS Plus sutures should be used for abdominal closure.

Cited by 22 publications

References 17 publications

Meta-analysis of the potential economic impact following introduction of absorbable antimicrobial sutures

Meta-analysis of the potential economic impact following introduction of absorbable antimicrobial sutures

Evaluation of safety and efficacy of polyglactin 910 suture in surgical incision closure: clinical study protocol for a randomized controlled trial

Correlation Between Postoperative Hyperglycemia and the Occurrence of Surgical Site Infections After Surgery for Gastroenterological Malignancy: A Retrospective Analysis

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