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Efficacy of a Dual-ring Wound Protector for Prevention of Surgical Site Infections After Pancreaticoduodenectomy in Patients With Intrabiliary Stents: A Randomized Clinical Trial.
Bressan, Alexsander K; Aubin, Jean-Michel; Martel, Guillaume; Dixon, Elijah; Bathe, Oliver F; Sutherland, Francis R; Balaa, Fady; Mimeault, Richard; Edwards, Janet P; Grondin, Sean C; Isherwood, Susan; Lillemoe, Keith D; Saeed, Sara; Ball, Chad G.
Afiliación
  • Bressan AK; Department of Surgery, University of Calgary, Calgary, Alberta, Canada.
  • Aubin JM; Department of Surgery, University of Ottawa, Ottawa, Ontario, Canada.
  • Martel G; Department of Surgery, University of Ottawa, Ottawa, Ontario, Canada.
  • Dixon E; Department of Surgery, University of Calgary, Calgary, Alberta, Canada.
  • Bathe OF; Department of Surgery, University of Calgary, Calgary, Alberta, Canada.
  • Sutherland FR; Department of Surgery, University of Calgary, Calgary, Alberta, Canada.
  • Balaa F; Department of Surgery, University of Ottawa, Ottawa, Ontario, Canada.
  • Mimeault R; Department of Surgery, University of Ottawa, Ottawa, Ontario, Canada.
  • Edwards JP; Department of Surgery, University of Calgary, Calgary, Alberta, Canada.
  • Grondin SC; Department of Surgery, University of Calgary, Calgary, Alberta, Canada.
  • Isherwood S; Department of Surgery, University of Calgary, Calgary, Alberta, Canada.
  • Lillemoe KD; Department of Surgery, Harvard University, Boston MA.
  • Saeed S; Department of Surgery, University of Ottawa, Ottawa, Ontario, Canada.
  • Ball CG; Department of Surgery, University of Calgary, Calgary, Alberta, Canada.
Ann Surg ; 268(1): 35-40, 2018 07.
Article en En | MEDLINE | ID: mdl-29240005
OBJECTIVE: To evaluate the efficacy of a dual-ring wound protector for preventing incisional surgical site infection (SSI) among patients with preoperative biliary stents undergoing pancreaticoduodenectomy (PD). METHODS AND ANALYSIS: This study was a parallel, dual-arm, double-blind randomized controlled trial. Adult patients with a biliary stent undergoing elective PD at 2 tertiary care institutions were included (February 2013 to May 2016). Patients were randomly assigned to receive a surgical dual-ring wound protector or no wound protector, and also the current standard of care. The main outcome measure was incisional SSI, as defined by the Centers for Disease Control and Prevention criteria, within 30 days of the index operation. RESULTS: A total of 107 patients were recruited (mean age 67.2 years; standard deviation 12.9; 65% male). No significant differences were identified between the intervention and control groups (age, sex, body mass index, preoperative comorbidities, American Society of Anesthesiologists class, prestent cholangitis). There was a significant reduction in the incidence of incisional SSI in the wound protector group (21.1% vs 44.0%; relative risk reduction 52%; P = 0.010). Patients with completed PD also displayed a decrease in incisional SSI with use of the wound protector compared with those palliated surgically (27.3% vs 48.7%; P = 0.04). Multivariate analysis did not identify any significant modifying factor relationships (estimated blood loss, duration of surgery, hospital site, etc.) (P > 0.05). CONCLUSION: Among adult patients with intrabiliary stents, the use of a dual-ring wound protector during PD significantly reduces the risk of incisional SSI.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Infección de la Herida Quirúrgica / Stents / Pancreaticoduodenectomía Tipo de estudio: Clinical_trials / Etiology_studies / Incidence_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Adolescent / Adult / Aged / Aged80 / Female / Humans / Male / Middle aged Idioma: En Revista: Ann Surg Año: 2018 Tipo del documento: Article País de afiliación: Canadá Pais de publicación: Estados Unidos
Texto completo
Añadir a Mi BVS
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XML
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Infección de la Herida Quirúrgica / Stents / Pancreaticoduodenectomía Tipo de estudio: Clinical_trials / Etiology_studies / Incidence_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Adolescent / Adult / Aged / Aged80 / Female / Humans / Male / Middle aged Idioma: En Revista: Ann Surg Año: 2018 Tipo del documento: Article País de afiliación: Canadá Pais de publicación: Estados Unidos