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The gentamicin–collagen sponge for surgical site infection prophylaxis in colorectal surgery: a prospective case-matched study of 606 cases

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Abstract

Purpose

Surgical site infection (SSI) is a major concern in colorectal surgery (CRS). It accounts for 60 % of all postoperative complications and has an incidence of between 10 and 30 %. The gentamicin–collagen sponge (GCS) was developed to help avoid SSI. The aim of this study was the evaluation of the efficacy of a GCS in preventing SSI after CRS.

Method

This study was a retrospective analysis of data collected in a prospective database. Six hundred six CRS patients were enrolled in the study and prospectively assigned to one of two groups. From January 2007 to December 2008, all procedures were performed without the use of GCS (forming the non-GCS group). From January 2009 to July 2011, all procedures included a GCS (forming the GCS group). The primary endpoint was the presence or absence of SSI at postoperative day 30.

Results

The incidence of SSI was 29.7 and 20.8 % in the non-GCS and GCS groups, respectively (p = 0.019). By using a stepwise logistic regression, the predictors of SSI were found to be ASA grade (p < 0.001), operating time (log-transformed value, p < 0.001), gender (p = 0.021), and GCS use (p < 0.001). By adjusting on these variables, a mean reduction in postoperative hospitalization of 8.3 days was found in the GCS group. The proportions of Clavien IIIB–V were 16.6 and 8.9 % for the non-GCS and GCS groups, respectively (p = 0.041).

Conclusions

This study provides additional evidence of the efficacy of the GCS in reducing SSI rates and shortening hospitalization after CRS.

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Acknowledgments

The Association for Research in Surgery, Gastroenterology and Hepatology (Chairperson, JM Regimbeau; Secretary, O. Brehant) has received an unconditioned grant from EUSA Pharma (3 Allée des Sequoias, F-69760 Limonest, France) to conduct the trial. Professor Ph Lehert has received an unconditioned grant from EUSA Pharma to conduct the statistical analysis of this trial.

Conflict of interest

The sponsor of the study had no role in study design, data collection, data analysis, data interpretation, or writing of the report. The GCS was not provided free of price by the sponsor. No contract of confidentiality or request of the company to review the results was signed. The remaining authors have nothing to declare.

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Authors and Affiliations

  1. Department of Digestive Surgery, Amiens University Medical Center, Place Victor Pauchet, 80054, Amiens cedex 01, France

    Olivier Brehant, Charles Sabbagh, Abdennaceur Dhahri, Lionel Rebibo & Jean Marc Regimbeau

  2. Faculty of Medicine, Department of Community Health, University of Melbourne, Melbourne, Australia

    Philippe Lehert

  3. Statistics Department, Faculty of Economics, FUCAM, Louvain Academy, Louvain, Belgium

    Philippe Lehert

Authors
  1. Olivier Brehant
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  2. Charles Sabbagh
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  3. Philippe Lehert
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  4. Abdennaceur Dhahri
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  5. Lionel Rebibo
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  6. Jean Marc Regimbeau
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Corresponding author

Correspondence to Jean Marc Regimbeau.

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Brehant, O., Sabbagh, C., Lehert, P. et al. The gentamicin–collagen sponge for surgical site infection prophylaxis in colorectal surgery: a prospective case-matched study of 606 cases. Int J Colorectal Dis 28, 119–125 (2013). https://doi.org/10.1007/s00384-012-1557-9

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  • DOI: https://doi.org/10.1007/s00384-012-1557-9

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