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World Journal of Surgery

, Volume 42, Issue 9, pp 3000–3007 | Cite as

A Novel Wound Retractor Combining Continuous Irrigation and Barrier Protection Reduces Incisional Contamination in Colorectal Surgery

  • Harry T. Papaconstantinou
  • Rocco Ricciardi
  • David A. Margolin
  • Roberto Bergamaschi
  • Robert C. Moesinger
  • Warren E. Lichliter
  • Elisa H. Birnbaum
Original Scientific Report

Abstract

Background

Surgical site infection (SSI) remains a persistent and morbid problem in colorectal surgery. Key to its pathogenesis is the degree of intraoperative bacterial contamination at the surgical site. The purpose of this study was to evaluate a novel wound retractor at reducing bacterial contamination.

Methods

A prospective multicenter pilot study utilizing a novel wound retractor combining continuous irrigation and barrier protection was conducted in patients undergoing elective colorectal resections. Culture swabs were collected from the incision edge prior to device placement and from the exposed and protected incision edge prior to device removal. The primary and secondary endpoints were the rate of enteric and overall bacterial contamination on the exposed incision edge as compared to the protected incision edge, respectively. The safety endpoint was the absence of serious device-related adverse events.

Results

A total of 86 patients were eligible for analysis. The novel wound retractor was associated with a 66% reduction in overall bacterial contamination at the protected incision edge compared to the exposed incision edge (11.9 vs. 34.5%, P < 0.001), and 71% reduction in enteric bacterial contamination (9.5% vs. 33.3%, P < 0.001). The incisional SSI rate was 2.3% in the primary analysis and 1.2% in those that completed the protocol. There were no adverse events attributed to device use.

Conclusions

A novel wound retractor combining continuous irrigation and barrier protection was associated with a significant reduction in bacterial contamination. Improved methods to counteract wound contamination represent a promising strategy for SSI prevention (NCT 02413879).

Notes

Acknowledgements

The authors thank Jill Schafer, MS of NAMSA for statistical analysis; Jodi Kosel, BA, MBA of NAMSA for research support; Lisa Claude, MS of Prescient Surgical for editorial support; and the study co-investigators and research coordinators.

Funding

This study was funded by Prescient Surgical, Inc.

Compliance with ethical standards

Conflict of interest

All authors declare that they have no conflict of interest.

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Copyright information

© Société Internationale de Chirurgie 2018

Authors and Affiliations

  • Harry T. Papaconstantinou
    • 1
  • Rocco Ricciardi
    • 2
    • 3
  • David A. Margolin
    • 4
  • Roberto Bergamaschi
    • 5
  • Robert C. Moesinger
    • 6
  • Warren E. Lichliter
    • 7
  • Elisa H. Birnbaum
    • 8
  1. 1.Department of SurgeryBaylor Scott & White Healthcare, Texas A&M University College of MedicineTempleUSA
  2. 2.Massachusetts General HospitalBostonUSA
  3. 3.Department of SurgeryLahey Hospital and Medical CenterBurlingtonUSA
  4. 4.Department of Colon and Rectal SurgeryUniversity of Queensland, Ochsner Clinical SchoolNew OrleansUSA
  5. 5.Division of Colon and Rectal SurgeryState University at Stony BrookStony BrookUSA
  6. 6.Northern Utah Surgeons, Intermountain HealthcareUniversity of UtahOgdenUSA
  7. 7.Baylor University Medical CenterDallasUSA
  8. 8.Department of Surgery, Section of Colon and Rectal SurgeryWashington University School of MedicineSt. LouisUSA

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