Shunji Endo1, Toshimasa Tsujinaka2,3, Kazumasa Fujitani2,4, Junya Fujita5,6, Shigeyuki Tamura7, Makoto Yamasaki8, Shogo Kobayashi8,9, Yusuke Akamaru10, Tsunekazu Mizushima8, Junzo Shimizu11, Koji Umeshita8, Toshinori Ito8, Masaki Mori8, Yuichiro Doki8. 1. Department of Gastroenterological Surgery, Higashiosaka City General Hospital, Osaka, Japan. endo-s@higashiosaka-hosp.jp. 2. Department of Surgery, National Hospital Organization Osaka National Hospital, Osaka, Japan. 3. Department of Surgery, Kaizuka City Hospital, Osaka, Japan. 4. Department of Surgery, Osaka General Medical Center, Osaka, Japan. 5. Department of Gastroenterological Surgery, Toyonaka Municipal Hospital, Osaka, Japan. 6. Department of Surgery, NTT WEST Osaka Hospital, Osaka, Japan. 7. Department of Surgery, Kansai Rosai Hospital, Hyogo, Japan. 8. Department of Gastroenterological Surgery, Osaka University Graduate School of Medicine, Osaka, Japan. 9. Department of Surgery, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan. 10. Department of Surgery, Japan Community Health Care Organization Osaka Hospital, Osaka, Japan. 11. Department of Surgery, Osaka Rosai Hospital, Osaka, Japan.
Abstract
BACKGROUND: Surgical site infection is one of the commonest complications of gastrointestinal surgery. The nature of surgical procedures and wound closure methods may influence the incidence of superficial incisional surgical site infection. Patients enrolled in a prospective randomized controlled trial comparing skin closure methods are the best subjects for analyzing surgical site infection risk. METHOD: From a cohort of 1080 patients who had been enrolled in our previous randomized controlled trial, data for 685 patients who had undergone elective open total gastrectomy or distal gastrectomy for gastric cancer were extracted. The incidences of superficial incisional surgical site infection after total gastrectomy and distal gastrectomy were compared and risk factors for superficial incisional surgical site infection were investigated by univariate analyses using logistic regression models. RESULTS: In all, 42 patients (6.1 %) developed superficial incisional surgical site infections after gastrectomy; 15 of 288 patients (5.2 %) developed these infections after total gastrectomy, and 27 of 397 patients (6.8 %) developed these infections after distal gastrectomy-these differences are not significant. According to univariate analysis, age (75 years or older or younger than 75 years) was the only risk factor for superficial incisional surgical site infections (P = 0.049). There was a tendency for the incidence of superficial incisional surgical site infection to increase in parallel with age. CONCLUSION: The incidence of superficial incisional surgical site infection did not differ between total gastrectomy and distal gastrectomy. Advanced age was the only identified risk factor for superficial incisional surgical site infections after gastrectomy.
RCT Entities:
BACKGROUND: Surgical site infection is one of the commonest complications of gastrointestinal surgery. The nature of surgical procedures and wound closure methods may influence the incidence of superficial incisional surgical site infection. Patients enrolled in a prospective randomized controlled trial comparing skin closure methods are the best subjects for analyzing surgical site infection risk. METHOD: From a cohort of 1080 patients who had been enrolled in our previous randomized controlled trial, data for 685 patients who had undergone elective open total gastrectomy or distal gastrectomy for gastric cancer were extracted. The incidences of superficial incisional surgical site infection after total gastrectomy and distal gastrectomy were compared and risk factors for superficial incisional surgical site infection were investigated by univariate analyses using logistic regression models. RESULTS: In all, 42 patients (6.1 %) developed superficial incisional surgical site infections after gastrectomy; 15 of 288 patients (5.2 %) developed these infections after total gastrectomy, and 27 of 397 patients (6.8 %) developed these infections after distal gastrectomy-these differences are not significant. According to univariate analysis, age (75 years or older or younger than 75 years) was the only risk factor for superficial incisional surgical site infections (P = 0.049). There was a tendency for the incidence of superficial incisional surgical site infection to increase in parallel with age. CONCLUSION: The incidence of superficial incisional surgical site infection did not differ between total gastrectomy and distal gastrectomy. Advanced age was the only identified risk factor for superficial incisional surgical site infections after gastrectomy.
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