Sönke Scheunemann1,2, Lars Daenenfaust3, Mike Ralf Langenbach4,5. 1. Department for General and Abdominal Surgery, Evangelical Hospital, Evangelisches Krankenhaus Lippstadt gGmbH, Wiedenbrücker Str.33, 59555, Lippstadt, Germany. 2. University of Witten/Herdecke, Witten, Germany. 3. Institute for Health Economics and Clinical Epidemiology (IGKE), University of Cologne, Cologne, Germany. 4. Department for General and Abdominal Surgery, Evangelical Hospital, Evangelisches Krankenhaus Lippstadt gGmbH, Wiedenbrücker Str.33, 59555, Lippstadt, Germany. mrlangenbach@aol.com. 5. University of Witten/Herdecke, Witten, Germany. mrlangenbach@aol.com.
Abstract
PURPOSE: A totally implantable vascular access port (TIVAP) is commonly required in cancer patients. Possible adverse events after TIVAP implantation include surgical site infection (SSI) and port-related bacteremia. This study examined whether adhesive surgical drapes can reduce the risk of SSI. METHODS: A total of 100 mostly cancer patients were randomized into two groups before undergoing TIVAP implantation by surgical cut-down. In one group, an adhesive, non-impregnated drape was applied to the skin prior to incision, while the control group underwent surgery without a drape. Swabs were taken from the surgical site and sent for microbiologic testing. SSI rates were compared between groups. RESULTS: No SSI occurred within 30 days after surgery. In each group, two patients died. There were 5 complications (port thrombosis, port dislocation, two cases of pneumothorax, skin allergy), all in the intervention group (p = 0.056). Using the incision drape prolonged procedure time by + 5 min (95% CI - 1 to + 10, p = 0.125). Microbiologic swab testing failed to detect any effect of the incision drape. CONCLUSIONS: Plastic adhesive skin drapes may be unnecessary in cancer patients who undergo surgical implantation of a TIVAP.
PURPOSE: A totally implantable vascular access port (TIVAP) is commonly required in cancer patients. Possible adverse events after TIVAP implantation include surgical site infection (SSI) and port-related bacteremia. This study examined whether adhesive surgical drapes can reduce the risk of SSI. METHODS: A total of 100 mostly cancer patients were randomized into two groups before undergoing TIVAP implantation by surgical cut-down. In one group, an adhesive, non-impregnated drape was applied to the skin prior to incision, while the control group underwent surgery without a drape. Swabs were taken from the surgical site and sent for microbiologic testing. SSI rates were compared between groups. RESULTS: No SSI occurred within 30 days after surgery. In each group, two patients died. There were 5 complications (port thrombosis, port dislocation, two cases of pneumothorax, skin allergy), all in the intervention group (p = 0.056). Using the incision drape prolonged procedure time by + 5 min (95% CI - 1 to + 10, p = 0.125). Microbiologic swab testing failed to detect any effect of the incision drape. CONCLUSIONS: Plastic adhesive skin drapes may be unnecessary in cancer patients who undergo surgical implantation of a TIVAP.