O-Ring Protector in Prevention of SSIs in Laparoscopic Colorectal Surgery

Background: Surgical-site infections (SSIs) remain a serious complication of colorectal surgery, causing a significant financial burden to the health care system. The aim of this study is to investigate whether the use of an O-ring retractor can be effective in preventing the incidence of wound infections after elective laparoscopic colorectal surgery. Methods: A retrospective case-control study from January 2014 to June 2018 was performed. Data were analyzed from a retrospective colorectal database. SSI was defined according to criteria published by the European Centre for Disease Prevention and Control and analyzed as a primary outcome. Results: Three hundred twelve consecutive patients (n = 312) were enrolled in our study. Among them, 158 patients (Group A) in which an O-ring retractor device was used during surgery was compared with a control group of 154 patients (Group B) in which an O-ring retractor device was not used. Primary outcome was to determine SSIs rates among the 2 groups. No statistically differences were observed with regard to baseline characteristics between both groups. A total of 9 patients (5.69%) and 24 (15.58%) with SSIs were identified in Group A and B, respectively, and the difference was statistically significant (OR, 0.32; 95% CI, 0.14–0.72; P = .0045). The median postoperative hospital stay length was 6.7 days in group A and 7.6 days in group B (P ≤ .05). Conclusions: SSIs infections rates were significantly higher in patients in which an O-ring retractor device was not used. This study suggests that the use of a wound protector device can be considered for routine use in elective colorectal surgery.

[1]  Min Hyun Kim,et al.  Systematic review and meta‐analysis of randomized controlled trials of the clinical effectiveness of impervious plastic wound protectors in reducing surgical site infections in patients undergoing abdominal surgery , 2018, Surgery.

[2]  F. Gudiol,et al.  Risk factors and outcomes of organ-space surgical site infections after elective colon and rectal surgery , 2017, Antimicrobial Resistance & Infection Control.

[3]  M. Sajid,et al.  A systematic review of clinical effectiveness of wound edge protector devices in reducing surgical site infections in patients undergoing abdominal surgery , 2017, Updates in Surgery.

[4]  Agustín Martínez,et al.  Reduced wound infection in colorectal resection by using a wound auto-retractor. , 2016, Le infezioni in medicina : rivista periodica di eziologia, epidemiologia, diagnostica, clinica e terapia delle patologie infettive.

[5]  R. Bergamaschi,et al.  Impact of a surgical site infection reduction strategy after colorectal resection , 2016, Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland.

[6]  A. Murray,et al.  Risk of Surgical Site Infection Varies Based on Location of Disease and Segment of Colorectal Resection for Cancer , 2016, Diseases of the colon and rectum.

[7]  P. T. Phang,et al.  Surgical Site Infection Rates Following Implementation of a Colorectal Closure Bundle in Elective Colorectal Surgeries , 2015, Diseases of the colon and rectum.

[8]  C. Edmiston,et al.  University of Huddersfield Repository Do surgical care bundles reduce the risk of surgical site infections in patients undergoing colorectal surgery? A systematic review and cohort meta-analysis of 8,515 patients in patients undergoing , 2022 .

[9]  C. Edmiston,et al.  Surgical site infection: poor compliance with guidelines and care bundles , 2015, International wound journal.

[10]  M. Hawn,et al.  Oral Antibiotic Bowel Preparation Significantly Reduces Surgical Site Infection Rates and Readmission Rates in Elective Colorectal Surgery. , 2015, Annals of surgery.

[11]  B. Tilley,et al.  An evaluation of differences in risk factors for individual types of surgical site infections after colon surgery. , 2014, Surgery.

[12]  R. Cima,et al.  Colorectal surgery surgical site infection reduction program: a national surgical quality improvement program--driven multidisciplinary single-institution experience. , 2013, Journal of the American College of Surgeons.

[13]  M. Hawn,et al.  Preoperative Oral Antibiotics Reduce Surgical Site Infection Following Elective Colorectal Resections , 2012, Diseases of the colon and rectum.

[14]  C. Law,et al.  ALEXIS O‐Ring wound retractor vs conventional wound protection for the prevention of surgical site infections in colorectal resections 1 , 2012, Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland.

[15]  M. Hawn,et al.  Surgical Site Infection Prevention: Time to Move Beyond the Surgical Care Improvement Program , 2011, Annals of surgery.

[16]  X. Guirao,et al.  Surgical site infection in elective operations for colorectal cancer after the application of preventive measures. , 2011, Archives of surgery.

[17]  K. Tabuse,et al.  A wound protector shields incision sites from bacterial invasion. , 2010, Surgical infections.

[18]  B. Draganic,et al.  Barrier Wound Protection Decreases Surgical Site Infection in Open Elective Colorectal Surgery: A Randomized Clinical Trial , 2010, Diseases of the colon and rectum.

[19]  G. de Lissovoy,et al.  Surgical site infection: incidence and impact on hospital utilization and treatment costs. , 2009, American journal of infection control.

[20]  Sergio Huerta,et al.  Surgical site infections after colorectal surgery: do risk factors vary depending on the type of infection considered? , 2007, Surgery.

[21]  M. Inoue,et al.  Randomized, controlled investigation of the anti-infective properties of the Alexis retractor/protector of incision sites. , 2007, The Journal of trauma.

[22]  W J Martone,et al.  CDC definitions of nosocomial surgical site infections, 1992: a modification of CDC definitions of surgical wound infections. , 1992, American journal of infection control.

[23]  P. Nyström,et al.  A controlled trial of a plastic wound ring drape to prevent contamination and infection in colorectal surgery , 1984, Diseases of the colon and rectum.

[24]  P. Fuchs,et al.  Antimicrobial prophylaxis in elective colon surgery. Experience of 1,035 operations in a community hospital. , 1984, American journal of surgery.

[25]  J. Rissing,et al.  Prophylactic antibiotics in colon surgery. , 1983, Archives of surgery.

[26]  M. Wheeler,et al.  The role of plastic wound drapes in the prevention of wound infection following abdominal surgery , 1977, The British journal of surgery.