BACKGROUND: Perineal wound infection (PWI) after abdominoperineal resection causes a burden for patients and health systems. We sought to determine the effect of patient positioning on the incidence of postoperative surgical site infection. METHODS: We conducted a retrospective cohort study of patients who underwent APR in our hospital system over a 10-year period. Univariate analysis was performed to identify characteristics associated with position and PWI. A logistic model was developed to assess the relationship of position and PWI, with adjustment for confounders. RESULTS: Patient characteristics were similar for the prone and lithotomy positions. Operative time was less for the prone than for the lithotomy position. The prone position was associated with a reduced risk of PWI. After adjustment for potential confounders, the prone position remained significantly associated with a reduction in PWI. CONCLUSIONS: Positioning patients in the prone position results in a lower occurrence of postoperative PWI and shorter operative time. We advocate this technique for most indications of APR.
BACKGROUND: Perineal wound infection (PWI) after abdominoperineal resection causes a burden for patients and health systems. We sought to determine the effect of patient positioning on the incidence of postoperative surgical site infection. METHODS: We conducted a retrospective cohort study of patients who underwent APR in our hospital system over a 10-year period. Univariate analysis was performed to identify characteristics associated with position and PWI. A logistic model was developed to assess the relationship of position and PWI, with adjustment for confounders. RESULTS:Patient characteristics were similar for the prone and lithotomy positions. Operative time was less for the prone than for the lithotomy position. The prone position was associated with a reduced risk of PWI. After adjustment for potential confounders, the prone position remained significantly associated with a reduction in PWI. CONCLUSIONS: Positioning patients in the prone position results in a lower occurrence of postoperative PWI and shorter operative time. We advocate this technique for most indications of APR.
Authors: Jose Wilson B Mesquita-Neto; Hassan Mouzaihem; Francisco Igor B Macedo; Lance K Heilbrun; Donald W Weaver; Steve Kim Journal: J Surg Oncol Date: 2019-02-06 Impact factor: 3.454
Authors: Hang Cheng; Brian Po-Han Chen; Ireena M Soleas; Nicole C Ferko; Chris G Cameron; Piet Hinoul Journal: Surg Infect (Larchmt) Date: 2017 Aug/Sep Impact factor: 2.150