학술논문
Prevalence and predictors of surgical site infections after bowel resection for Crohn's disease: the role of dual-ring wound protector
Original Article
Original Article
Document Type
Academic Journal
Author
Source
International Journal of Colorectal Disease. May 1, 2019, Vol. 34 Issue 5, p879, 9 p.
Subject
Language
English
ISSN
0179-1958
Abstract
Author(s): Xiaolong Ge [sup.1] [sup.2], Shasha Tang [sup.1], Weilin Qi [sup.1] [sup.2], Wei Liu [sup.1] [sup.2], Jiemin Lv [sup.1], Qian Cao [sup.2] [sup.3], Wei Zhou [sup.1] [sup.2], Xiujun Cai [sup.1] [...]
Purpose Surgical site infections (SSIs) have become a leading cause of preventable morbidity and mortality in surgery. The aim was to evaluate the efficacy of a dual-ring wound protector to prevent the SSIs in Crohn's disease (CD) after bowel resection. Methods This retrospective observational study included all CD patients undergoing bowel resection at the Inflammatory Bowel Disease Center between January 2015 and June 2018 at Sir Run Run Shaw Hospital. Risk factors of SSIs were evaluated by assessing preoperative clinical characteristics and perioperative treatments in univariate and multivariate analyses. Outcomes for CD patients with and without the wound protector were compared. Results Three hundred forty-four CD patients were enrolled in this study, 121 (35.2%) patients had postoperative complications, of whom, 72 (20.9%) patients developed SSIs (12.8% patients with incisional SSI and 8.1% patients with organ/space SSI). There was a significant reduction in the incidence of incisional SSI in the wound protector group (8.1% vs 16.8%, p < 0.05). No significant differences were identified in organ/space SSI between groups with and without wound protector (6.3% vs 9.8%, p = 0.232). Incisional SSI correlated with preoperative albumin, C-reactive protein, white blood cell, age ([less than or equal to] 16), penetrating disease behavior, surgical history, open surgery, stoma creation, estimated blood loss, infliximab, and wound protector (p < 0.05). Multivariate analysis identified the wound protector to be one of independent factors for preventing incisional SSIs (OR 0.357, 95% CI 0.161-0.793, p < 0.05). Conclusion Among the CD patients with bowel resection, the use of a dual-ring wound protector during surgery significantly reduced the risk of incisional SSI.
Purpose Surgical site infections (SSIs) have become a leading cause of preventable morbidity and mortality in surgery. The aim was to evaluate the efficacy of a dual-ring wound protector to prevent the SSIs in Crohn's disease (CD) after bowel resection. Methods This retrospective observational study included all CD patients undergoing bowel resection at the Inflammatory Bowel Disease Center between January 2015 and June 2018 at Sir Run Run Shaw Hospital. Risk factors of SSIs were evaluated by assessing preoperative clinical characteristics and perioperative treatments in univariate and multivariate analyses. Outcomes for CD patients with and without the wound protector were compared. Results Three hundred forty-four CD patients were enrolled in this study, 121 (35.2%) patients had postoperative complications, of whom, 72 (20.9%) patients developed SSIs (12.8% patients with incisional SSI and 8.1% patients with organ/space SSI). There was a significant reduction in the incidence of incisional SSI in the wound protector group (8.1% vs 16.8%, p < 0.05). No significant differences were identified in organ/space SSI between groups with and without wound protector (6.3% vs 9.8%, p = 0.232). Incisional SSI correlated with preoperative albumin, C-reactive protein, white blood cell, age ([less than or equal to] 16), penetrating disease behavior, surgical history, open surgery, stoma creation, estimated blood loss, infliximab, and wound protector (p < 0.05). Multivariate analysis identified the wound protector to be one of independent factors for preventing incisional SSIs (OR 0.357, 95% CI 0.161-0.793, p < 0.05). Conclusion Among the CD patients with bowel resection, the use of a dual-ring wound protector during surgery significantly reduced the risk of incisional SSI.