The Results of a Propensity Score Matching Analysis of the Efficacy of Abdominal Fascia and Skin Closure Using PDS® Plus Antibacterial (Polydioxanone) Sutures on the Incidence of Superficial Incisional Surgical Site Infections after Gastroenterologic Surgery

2016 ◽  
Vol 17 (1) ◽  
pp. 94-99 ◽  
Author(s):  
Shinsuke Takeno ◽  
Kanefumi Yamashita ◽  
Yuichi Yamashita ◽  
Kazunosuke Yamada ◽  
Seichiro Hoshino ◽  
...  
2017 ◽  
Vol 102 (1-2) ◽  
pp. 58-63
Author(s):  
Shinsuke Takeno ◽  
Kanefumi Yamashita ◽  
Tomoaki Noritomi ◽  
Seichiro Hoshino ◽  
Yasushi Yamauchi ◽  
...  

Superficial surgical site infections (S-SSIs), which prolonged hospital stay and increased costs, are a critical problem. The aim of the present study was to clarify the risk factors for S-SSIs after urgent gastroenterologic surgery and what surgeons can do to reduce their incidence and to shorten the hospital stay. A total of 275 patients who underwent urgent gastroenterologic surgery were enrolled in the present study. The correlations between the incidence of S-SSIs and clinicopathologic factors were retrospectively analyzed using propensity score matching. Of 275 cases, 43 (15.6%) patients had an S-SSI. On univariate analysis, the following factors were associated with a significantly higher incidence of S-SSI: American Society of Anesthesiologists score (P = 0.043); wound classification (P = 0.0005); peritonitis (P = 0.019); prolonged operation time (P = 0.0001); increased blood loss (P = 0.019); transfusion (P = 0.0047); and abdominal closure without triclosan-coated polydioxanone sutures (P = 0.042). However, a propensity score–matching analysis showed that abdominal closure using triclosan-coated polydioxanone sutures did not reduce the incidence of S-SSIs in patients who underwent urgent gastroenterologic surgery (P = 0.20), but it tended to be associated with a shorter hospital stay (P = 0.082). To reduce morbidity after urgent gastroenterologic surgery, surgeons should shorten the operation time and decrease the blood loss. In addition, abdominal closure using triclosan-coated polydioxanone sutures alone could not reduce the incidence of S-SSIs but might shorten the hospital stay after urgent gastroenterologic surgery by inhibiting bacterial activity and preventing prolongation of the infections.


2018 ◽  
Vol 84 (2) ◽  
pp. 230-237 ◽  
Author(s):  
Yoshihiro Inoue ◽  
Yusuke Suzuki ◽  
Masato Ota ◽  
Kensuke Fujii ◽  
Nao Kawaguchi ◽  
...  

The aim of this study was to evaluate the degree of invasiveness and the clinical outcomes of laparoscopic parenchyma-sparing hepatectomy (LPSH) for a maximum hepatocellular carcinoma (HCC) size ≤5 cm. Sixty-one LPSHs and 175 open parenchyma-sparing hepatectomies (OPSHs) for small-sized HCC were analyzed using a propensity score matching analysis. The median operative time was significantly shorter in the LPSH group (194 min) than in the OPSH group (275 minutes) ( P < 0.0001). The estimated blood loss was significantly lower in the LPSH group (100 mL) than in the OPSH group (380 mL) ( P < 0.0001). The incidences of superficial incisional surgical site infections and respiratory complications were significantly lower in the LPSH group than in the OPSH group ( P = 0.0161 and 0.0285, respectively). During the postoperative course, the white blood cell counts and C-reactive protein levels were significantly lower in the LPSH group. There were no differences in overall survival and disease-free survival ( P = 0.1293 and 0.4039, respectively), and no significant differences in terms of type of recurrence and site of intrahepatic recurrence ( P = 0.1410). The data from the present series suggest the lesser invasiveness and safety of LPSH even for small-sized HCC patients.


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