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Dual-ring wound protectors cut infection risk in GI surgery
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The use of dual-ring wound protectors during lower gastrointestinal surgery was associated with a reduced risk for surgical site infection, according to a meta-analysis published in Surgical Endoscopy.
Lisa Zhang , MD, of the department of surgery at Kingston General Hospital, Canada, and colleagues wrote that the use of these devices could greatly reduce the cost associated with post-operative complications linked to surgical site infections (SSIs).
“Surgical site infection is a common complication in the setting of gastrointestinal surgery, with reported infection rates between 4.0% and 25.2%,” the researchers wrote. “SSIs can increase hospital length of stay, incur increased costs and contribute to postoperative mortality.”
The investigators searched the MEDLINE and EMBASE databases between 1946 and 2016 to find randomized controlled trials that compared lower gastrointestinal surgeries performed with wound protectors vs. surgeries performed without them. The primary outcome was SSI, and the researchers conducted a subgroup analysis to compare single- and dual-ring protectors.
Zhang and colleagues identified 12 randomized controlled trials totaling 3,029 patients in the databases. Seven of the studies used single-ring protectors, while 5 studies used dual-ring protectors, such as the Alexis O-Ring retractor (Applied Medical). They found a significant reduction in odds for developing SSI in the wound protector group (OR = 0.64; 95% CI, 0.45–0.9; I² = 55%).
In the subgroup analysis, the researchers found evidence of a subgroup effect (P = .01) with dual-ring protectors correlating with a significantly lower incidence of SSIs (OR = 0.31; 95% CI, 0.18–0.52; I² = 12%), which they did not find in the single-ring group (OR = 0.84; 95% CI, 0.67–1.04; I² = 0%).
While they said further research is needed, Zhang and colleagues wrote that using dual-ring wound protectors for lower gastrointestinal surgeries could have a significant effect on health care costs.
“SSIs are believed to account for $3.5–$10 billion annually in health care expenditures,” Zhang and colleagues wrote. “Our data analysis suggests that the use of dual-ring wound edge protectors should be considered in open lower gastrointestinal surgery, including open appendectomies.” – by Alex Young
Disclosures : The authors report no relevant financial disclosures.
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