A Novel Wound Retractor Combining Continuous Irrigation and Barrier Protection Reduces Incisional Contamination in Colorectal Surgery

Background Surgical site infection (SSI) remains a persistent and morbid problem in colorectal surgery. Key to its pathogenesis is the degree of intraoperative bacterial contamination at the surgical site. The purpose of this study was to evaluate a novel wound retractor at reducing bacterial contam...

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Bibliographic Details
Published in:World journal of surgery 2018-09, Vol.42 (9), p.3000-3007
Main Authors: Papaconstantinou, Harry T., Ricciardi, Rocco, Margolin, David A., Bergamaschi, Roberto, Moesinger, Robert C., Lichliter, Warren E., Birnbaum, Elisa H.
Format: Article
Language:English
Subjects:
Abdominal Surgery
Bacteria
Cardiac Surgery
Colorectal surgery
Contamination
Exposure
General Surgery
Infectious diseases
Medicine
Medicine & Public Health
NCT
NCT 02413879
Original Scientific Report
Pathogenesis
Patients
Reduction
Surgery
Surgical site infections
Thoracic Surgery
Vascular Surgery
Wounds
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Summary:Background Surgical site infection (SSI) remains a persistent and morbid problem in colorectal surgery. Key to its pathogenesis is the degree of intraoperative bacterial contamination at the surgical site. The purpose of this study was to evaluate a novel wound retractor at reducing bacterial contamination. Methods A prospective multicenter pilot study utilizing a novel wound retractor combining continuous irrigation and barrier protection was conducted in patients undergoing elective colorectal resections. Culture swabs were collected from the incision edge prior to device placement and from the exposed and protected incision edge prior to device removal. The primary and secondary endpoints were the rate of enteric and overall bacterial contamination on the exposed incision edge as compared to the protected incision edge, respectively. The safety endpoint was the absence of serious device-related adverse events. Results A total of 86 patients were eligible for analysis. The novel wound retractor was associated with a 66% reduction in overall bacterial contamination at the protected incision edge compared to the exposed incision edge (11.9 vs. 34.5%, P  
ISSN:0364-2313
1432-2323
DOI:10.1007/s00268-018-4568-z