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

Abstract

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.

A meta‐analysis examined the effect of topical nursing application of antimicrobial as a prophylaxis for the stoppage of surgical wound infection in colorectal surgery

“…A total of 9160 participants with CS were enrolled in the chosen studies; 4719 of them used TA, while 4441 served as controls. From a total of 2367 applicable studies that were appraised, 39 papers between 1967 and 2022 that met the inclusion criteria and were encompassed in the meta‐analysis were selected 12‐50 …”

“…At the start of the investigations, 9160 participants with CS were enrolled in the chosen studies; 4719 of them used TA, while 4441 served as controls 12‐50 . Significantly lower SWIs post CS for TA as whole, GCA&D, TIFS, antibiotic powder, ointment, lavage, or injection for the abdominal wound (APOL), and ISD compared with control.…”

A meta‐analysis of the risk factors for surgical site infection in patients with colorectal cancer

“…23 tests that were published between 2001 and 2023 were included in the meta‐analysis after an evaluation of 2309 applicable studies since they fit the inclusion criteria 23–45 . Table 2 summarizes the findings of these investigations.…”

“…For the current meta‐analysis, 23 examinations from 2001 to 2023 were included; of these, 89 859 individuals with CCs were included in the beginning point of the used investigations, and 7548 of them had SSI. The sample size was 60–67 613 people 23–45 . Clean‐contaminated surgical site wounds had a significantly lower infection compared to contaminated surgical site wounds in patients with CCs.…”

Drug Delivery Systems in Regenerative Medicine: An Updated Review

“…In addition, collagen-based scaffolds are liable to be used to deliver a variety of molecules, including drugs [ 92 ], proteins, and genes [ 93 ]. Collagen-based gentamicin-delivery vehicles (e.g., Collatamp ® -G) are currently available and permit a sustained local delivery of antibiotics [ 94 ]. Another product (i.e., Septocoll ® ) is reported to achieve prolonged delivery by incorporating two gentamicin salts with different solubility rates [ 95 ].…”