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Micro-power negative pressure wound technique reduces risk of incision infection following loop ileostomy closure
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作者 Deng-Yong Xu Bing-Jun Bai +4 位作者 Lina Shan Hui-Yan Wei Deng-Feng Lin Ya Wang Da Wang 《World Journal of Gastrointestinal Surgery》 SCIE 2024年第1期186-195,共10页
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 complic... 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. 展开更多
关键词 Micro-power negative pressure technique Ileostomy closure incisional surgical site infection infection prevention Postoperative incision
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Incidence and risk factors for incisional surgical site infection in patients with Crohn’s disease undergoing bowel resection
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作者 Tuo Hu Xianrui Wu +7 位作者 Jiancong Hu Yufeng Chen Huashan Liu Chi Zhou Xiaowen He Min Zhi Xiaojian Wu Ping Lan 《Gastroenterology Report》 SCIE EI 2018年第3期189-194,共6页
Background:Patients with Crohn’s disease(CD)are often reported to be at a high risk for incisional surgical site infection(SSI).The aim of this study was to identify the risk factors associated with post-operative in... Background:Patients with Crohn’s disease(CD)are often reported to be at a high risk for incisional surgical site infection(SSI).The aim of this study was to identify the risk factors associated with post-operative incisional SSI in CD patients after bowel resection.Method:CD patients undergoing bowel resection between 2007 and 2015 were enrolled.Demographic and clinical features related to post-operative incisional SSI were analysed using both univariate and multivariate logistical analyses.Results:Of all eligible patients(n=159),123(77.4%)were male,with a mean age at surgery of 33.4611.8 years.A total of 35(22.0%)CD patients developed post-operative incisional SSI.Post-operative incisional SSI was more likely to happen in patients who had penetrating type of disease(P=0.018),underwent bowel resection for the indication of chronic fistula(P=0.005)and had an intra-operative finding of fistula(P=0.001).A greater proportion of patients with post-operative incisional SSI were found to have anemia(P=0.019)but elevated levels of white blood cells(P=0.027),neutrophils(P=0.006)as well as an elevated percentage of neutrophils(P=0.005).Multivariate logistic regression analysis showed that anemia(odds ratio[OR]:3.31,95%confidence interval[CI]:1.05-10.46,P=0.041),an elevated percentage of neutrophils(OR:2.85,95%CI:1.23-6.59,P=0.014)and an intra-operative finding of fistula(OR:3.76,95%CI:1.53-9.21,P=0.004)were significantly associated with the risk for post-operative incisional SSI.Conclusions:Anemia,elevated percentage of neutrophils and intra-operative finding of fistula are predictors for the development of post-operative incisional SSI in CD patients undergoing bowel resection.Favorable pre-operative nutrition status and low inflammatory status may lessen the incidence of post-operative incisional SSI. 展开更多
关键词 Crohn’s disease incisional surgical site infection risk factors bowel resection
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