Subcutaneous application of gentamicin collagen implants as prophylaxis of surgical site infections in laparoscopic colorectal surgery: a randomized, double-blinded, three-arm trial

Pochhammer, Julius; Zacheja, Steffi; Schäffer, Michael

doi:10.1007/s00423-014-1232-4

Cited by 15 publications

(10 citation statements)

References 36 publications

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“…Various studies have also used investigated the gentamicin-collage sponge in colorectal surgery [ 4 , 17 , 18 ]. A large-scale RCT [ 4 ] that involved all colorectal operations performed in 54 countries failed to prove the hypothesis that the gentamicin-collagen sponge would reduce the frequency of SSI.…”

Section: Discussionmentioning

confidence: 99%

“…A large-scale RCT [ 4 ] that involved all colorectal operations performed in 54 countries failed to prove the hypothesis that the gentamicin-collagen sponge would reduce the frequency of SSI. Similarly, an RCT [ 18 ] that included 291 patients who underwent laparoscopic colorectal surgery at a single center also failed to prove the efficacy of the gentamicin-collagen sponge. However, in a recent meta-analysis [ 5 ], a sensitivity analysis of abdominal wounds revealed that a gentamicin-collagen sponge could reduce SSI in colorectal surgery (RR, 0.38; 95% CI, 0.20–0.72).…”

Section: Discussionmentioning

confidence: 99%

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Use of gentamicin-collagen sponge (Collatamp® G) in minimally invasive colorectal cancer surgery: A propensity score-matched study

Lee

Park

et al. 2022

PLoS ONE

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Background Minimally invasive surgery is commonly used to treat patients with colorectal cancer, although it can cause surgical site infections (SSIs) that can affect the oncologic outcome. Use of a gentamicin-collagen sponge may help reduce the occurrence of SSIs. We aimed to determine the effectiveness of a gentamicin-collagen sponge in reducing SSIs in minimally invasive surgery for colorectal cancer. Methods We retrospectively reviewed the records of 310 patients who were diagnosed with colorectal cancer at our hospital and underwent minimally invasive surgery between December 1, 2018, and February 28, 2021. Propensity score matching was conducted with a 1:1 ratio using logistic regression. The primary outcome was the incidence of SSIs in the mini-laparotomy wound. The secondary endpoints were factors affecting the incidence of SSIs. Results After propensity score matching, 130 patients were assigned to each group. There were no differences in clinical characteristics between the two groups. SSIs occurred in 2 (1.5%) and 3 (2.3%) patients in the gentamicin-collagen sponge and control groups, respectively (p<0.999). The following factors showed a statistically significant association with SSIs: body mass index >25 kg/m2 (odds ratio, 39.0; 95% confidence interval, 1.90–802.21; p = 0.018), liver disease (odds ratio, 254.8; 95% confidence interval, 10.43–6222.61; p = 0.001), and right hemicolectomy (odds ratio, 36.22; 95% confidence interval, 2.37–554.63; p = 0.010). Conclusion Applying a gentamicin-collagen sponge to the mini-laparotomy wound did not reduce the frequency of SSIs. Further studies should be conducted on whether the selective use of gentamicin-collagen sponges may help reduce SSIs in high-risk patients.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Use of gentamicin-collagen sponge (Collatamp® G) in minimally invasive colorectal cancer surgery: A propensity score-matched study

Lee

Park

et al. 2022

PLoS ONE

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“…1,[11][12][13][14][15] Many researchers have demonstrated that the application of gentamicin sponges can significantly reduce the incidence of wound infection and kill pathogenic bacteria in both animal experiments and clinical studies. 5,16,17 However, there are also many scholars who believe that gentamicin sponges have no effect in the prevention or treatment of wound infections and that these sponges may in fact have the opposite effect and increase the incidence of infection. 1,7,8,18,19 In particular, a study with a large sample size was previously conducted to confirm these opinions.…”

Section: Discussionmentioning

confidence: 99%

A Preliminary Exploration of the Efficacy of Gentamicin Sponges in the Prevention and Treatment of Wound Infections

Li¹,

Zhou²

2021

IDR

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This study aimed to construct drug-loading and drug-releasing quantitative equations for gentamicin sponges in addition to realizing a gentamicin sponge for wound infection prevention and treatment. Methods: Sterile sponges were cut into pieces of 1×1 × 0.5 cm and immersed in 40, 16, 8, 4, 1.6, 0.8, or 0 mg/mL of gentamicin solution for 12, 24, 48, 96, or 120 h to evaluate their gentamicin loading. The sponges were subsequently immersed in the gentamicin solution of different concentrations for 48 h, air-dried, and then immersed in 10 mL of 0.9% physiological saline to evaluate the gentamicin release. Methicillin-sensitive Staphylococcus aureus (MSSA) and Pseudomonas aeruginosa were used to explore the sponges' infection prevention scheme. In addition, a rat femur fracture with wound infection model was used to assess the infection treatment scheme. Results: The antibacterial zone sizes of the sponges immersed in 40, 16, 8, 4, 1.6, and 0.8 mg/mL of the gentamicin solution were larger than those of the 0 mg/mL air-dried sponge, and the difference was statistically significant (p < 0.01, p < 0.01, p < 0.01, p < 0.01, p < 0.01, and p < 0.01, respectively). The rats in the 40, 16, and 8 mg/mL air-dried sponge groups had no wound suppuration in either the MSSA or P. aeruginosa rat infection models. Conclusion:A quantified equation for the sponges' gentamicin loading and release was achieved with high accuracy. Furthermore, we recommend the 40, 16, or 8 mg/mL air-dried sponge for the treatment of wounds with antibiotic-sensitive bacterial infections.

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“…Gentamicin-sponge has been studied for more than 30 years, but its e cacy is still controversial [1,[11][12][13][14][15]. Many researches have demonstrated that the application of gentamicin-sponge can signi cantly reduce the incidence of wound infections and kill pathogenic bacteria, whether in animal experiments or clinical studies [5,[16][17]. However, also many scholars believe that gentamicin-sponge has no effect on preventing or treating wound infection, and it maybe play an opposite role as increase the incidence of infection [1,[7][8][18][19].…”

Section: Discussionmentioning

confidence: 99%

Gentamicin Sponge for Anti-infection, a Controversial Old Topic and Preliminary Exploration of the Solution, in Vitro and in Vivo Experiments

Wang

Zhou

2021

Preprint

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Purpose: Our study was to construct drug-loading and drug-release quantitative equation of gentamicin sponge, in addition, obtain the wound infection prevented and treated scheme of gentamicin sponge. Methods: Sterile sponge was cut into 1×1×0.5cm size and immersed into 40mg/ml, 16mg/ml, 8mg/ml, 4mg/ml, 1.6mg/ml, 0.8mg/ml or 0mg/ml gentamicin solution for 12h, 24h, 48h, 96h or 120h to evaluate gentamicin-loading of sponge. Sponge was immersed in gentamicin solution of different concentrations for 48h and then air-dried. Air-dried sponge was immersed into 10ml 0.9% physiological saline to evaluated gentamicin-release. Staphylococcus aureus (MSSA) and Pseudomonas aeruginosa (P. aeruginosa) were used to explore infection prevented scheme of gentamicin sponge. Besides, femur fractured with wound infection rat model was used to discuss the infection treated scheme.Results: The equation of gentamicin-loading of sponge was: z=(0.03718±0.01672)x+(-4.578e-4±0.06253)y+(-2.50935e-4±1.47521e-4)x2+(0.00303±0.00149)y2+(0.00408±3.52827e-4)xy (R2 was 0.97) and drug-release equation was z=(4.37205±1.18048)x+(-7.05921±3.09628)y+(-0.04596±0.01287)x2+(0.3309±0.07912)y2+(0.31559±0.02754)xy (R2 was 0.95). The antibacterial zone sizes of sponges immersed in 40mg/ml, 16mg/ml, 8mg/ml, 4mg/ml, 1.6mg/ml, 0.8mg/ml gentamicin solution were larger than 0mg/ml air-dried sponge, and the difference had statistically significant (p<0.01). Rats of groups of 40mg/ml air-dried sponge, 16mg/ml air-dried sponge, 8mg/ml air-dried sponge had no wound suppuration in both MSSA and P. aeruginosa infection rat model.Conclusions: The quantified equation of gentamicin-loading and release of sponge was with high accuracy. 1.6 mg/ml air-dried sponge and 0.8mg/ml air-dried sponge were enough to prevent wound infection. Besides, if wound were confirmed to be sensitive bacteria infected, we recommended to use 40mg/ml air-dried sponge, 16mg/ml air-dried sponge or 8mg/ml air-dried sponge to treat.

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Subcutaneous application of gentamicin collagen implants as prophylaxis of surgical site infections in laparoscopic colorectal surgery: a randomized, double-blinded, three-arm trial

Abstract: The local administration of GCS showed no significant benefit regarding wound infection after standardized laparoscopic colorectal resections. However, there was a trend toward reduced SSI in the GCS group. Therefore, a larger trial or meta-analysis is necessary to validate this result.

Cited by 15 publications

References 36 publications

Use of gentamicin-collagen sponge (Collatamp® G) in minimally invasive colorectal cancer surgery: A propensity score-matched study

Use of gentamicin-collagen sponge (Collatamp® G) in minimally invasive colorectal cancer surgery: A propensity score-matched study

A Preliminary Exploration of the Efficacy of Gentamicin Sponges in the Prevention and Treatment of Wound Infections

Gentamicin Sponge for Anti-infection, a Controversial Old Topic and Preliminary Exploration of the Solution, in Vitro and in Vivo Experiments

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