Micro-power negative pressure wound technique reduces risk of incision infection following loop ileostomy closure

BACKGROUND Prophylactic loop ileostomy is an effective way to reduce the clinical severity of anastomotic leakage following radical resection of rectal cancer.Incisional surgical site infection(SSI)is a common complication after ileostomy closure.AIM To evaluate the efficacy and safety of the micro-power negative pressure wound technique(MPNPWT)in preventing incisional SSI.METHODS This was a prospective,randomized controlled clinical trial conducted at a single center.A total of 101 consecutive patients who underwent ileostomy closure after rectal cancer surgery with a prophylactic ileostomy were enrolled from January 2019 to December 2021.Patients were randomly allocated into an MPNPWT group and a control group.The MPNPWT group underwent intermittent suturing of the surgical incision with 2-0 Prolene and was covered with a micro-power negative pressure dressing.The surgical outcomes were compared between the MPNPWT(n=50)and control(n=51)groups.Risk factors for incisional SSI were identified using logistic regression.RESULTS There were no differences in baseline characteristics between the MPNPWT(n=50)and control groups(n=51).The incisional SSI rate was significantly higher in the control group than in the MPNPWT group(15.7%vs 2.0%,P=0.031).However,MPNPWT did not affect other surgical outcomes,including intra-abdominal complications,operative time,and blood loss.Postoperative hospital stay length and hospitalization costs did not differ significantly between the two groups(P=0.069 and 0.843,respectively).None of the patients experienced adverse effects of MPNPWT,including skin allergy,dermatitis,and pain.MPNPWT also helped heal the infected incision.Our study indicated that MPNPWT was an independent protective factor[odds ratio(OR)=0.005,P=0.025)]and diabetes was a risk factor(OR=26.575,P=0.029)for incisional SSI.CONCLUSION MPNPWT is an effective and safe way to prevent incisional SSI after loop ileostomy closure.

Mageb4,a Testis-Specific Gene,is Dispensable for Mouse Spermatogenesis

Objective:It has recently been shown that the melanoma antigen gene(MAGE)family is expressed in various tumor cell lines but silent in normal tissues,except germ cell lines.Mageb4,a member of the MAGE family,is highly expressed in the testis and homologous in humans and mice.Whole-exome sequencing studies have identifiedMageb4 as a possible X-linked cause of inherited male infertility.However,the function of Mageb4 protein remains largely unknown.Methods:Using clustered regularly interspaced palindromic repeats(CRISPR)/CRISPR-associated protein(Cas)9 technology,we generated aMageb4 knockout mouse model(Mageb4^-/Y)to explore the role of this gene in spermatogenesis.Results:First,immunostaining of testicular cells showed thatMageb4 is localized in the cytoplasm of spermatogonia.Second,Mageb4^-/Y male mice displayed significant increases in apoptosis.However,Mageb4^-/Y male mice showed normal fertility,including normal sperm concentration,sperm motility,and testicular and epididymal histology.Conclusions:These findings suggest that,despite testis-exclusive expression,Mageb4 is dispensable for mouse spermatogenesis.Future research should focus on the role of this gene in apoptosis,aiming to provide clinical guidance regarding male infertility.