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Plastic Iodophor Drape during Liver SurgeryOperative Use of the Iodophor-impregnated Adhesive Drape to Prevent Wound Infection during High Risk Surgery

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Abstract

We retrospectively investigated factors associated with wound infection after liver resection for hepatocellular carcinoma (HCC), with special reference to use of a plastic adhesive drape impregnated with iodophor. The subjects were 296 patients undergoing liver resection for HCC. Wound infection was defined as purulent drainage from the superficial incision with or without laboratory confirmation. One or more of the following signs was required: pain or tenderness, localized swelling, or redness or heat. Wound infection developed in 25 patients. Regression analysis indicated that low body mass index (BMI), smoking, long preoperative hospital stay, and nonuse of iodophor drapes were risk factors for wound infection. Wound infection was significantly less likely with the use of iodophor drapes (3.1%) than for surgery without iodophor drapes (12.1%). By multivariate regression analysis, BMI, smoking, and lack of drape use were independent risk factors. Most of the bacteria isolated were skin bacteria, including Staphylococcus aureus and Staphylococcus epidermidis. In conclusion, low BMI, smoking, a long preoperative hospital stay, and the lack of iodophor drape use were risk factors for wound infection after liver resection for HCC. The drapes presumably prevented contamination from the skin during the operation.

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References

  1. TC Horan RP Gaynes WJ Martone et al. (1992) ArticleTitleCDC definitions of nosocomial surgical site infections, 1992: a modification of CDC definitions of surgical wound infections Infect. Control Hosp. Epidemiol. 13 606–608 Occurrence Handle1:STN:280:ByyC3cjmsVQ%3D Occurrence Handle1334988

    CAS  PubMed  Google Scholar 

  2. AJ Mangram TC Horan ML Pearson et al. (1999) ArticleTitleThe Hospital Infection Control Practices Advisory Committee:guideline for prevention of surgical site infection, 1999 Infect. Control Hosp. Epidemiol. 20 250–278 Occurrence Handle1:STN:280:DyaK1M3jsFarsw%3D%3D Occurrence Handle10219875

    CAS  PubMed  Google Scholar 

  3. S Geroulanos (1991) ArticleTitleInfectious complications and risks in abdominal surgery; early recognition and prevention Hepatogastroenterology. 38 261–271 Occurrence Handle1:STN:280:By2D3sbksFM%3D Occurrence Handle1937368

    CAS  PubMed  Google Scholar 

  4. T Nagachinta M Stephens B Reitz et al. (1987) ArticleTitleRisk factors for surgical-wound infection following cardiac surgery J. Infect. Dis. 156 967–973 Occurrence Handle1:STN:280:BieD28%2Fmt1Y%3D Occurrence Handle3680996

    CAS  PubMed  Google Scholar 

  5. DE Lilienfeld MS Engiu D Vlahov et al. (1988) ArticleTitleObesity and diabetes as risk factors for postoperative wound infections after cardiac surgery Am. J. Infect. Control 16 3–6 Occurrence Handle1:STN:280:BieB38%2FotlU%3D Occurrence Handle3369746

    CAS  PubMed  Google Scholar 

  6. JV Roberts T Bates (1992) ArticleTitleThe use of the body mass index in studies of abdominal wound infection J. Hosp. Infect. 20 217–220 Occurrence Handle1:STN:280:By2B38nltlY%3D Occurrence Handle1348777

    CAS  PubMed  Google Scholar 

  7. MS Slaughter MM Olson JT Lee SuffixJr et al. (1993) ArticleTitleA fifteen-year wound surveillance study after coronary artery bypass Ann. Thorac. Surg. 56 1063–1068 Occurrence Handle10.1016/0003-4975(95)90014-4 Occurrence Handle1:STN:280:ByuD2MfktVw%3D Occurrence Handle8239800

    Article  CAS  PubMed  Google Scholar 

  8. GR Barber J Miransky AE Brown et al. (1995) ArticleTitleDirect observations of surgical wound infections at a comprehensive cancer center Arch. Surg. 130 1042–1047 Occurrence Handle1:STN:280:BymD2crlsFI%3D Occurrence Handle7575114

    CAS  PubMed  Google Scholar 

  9. RL Nichols (1996) ArticleTitleSurgical infections: prevention and treatment—1965 to 1995 Am. J. Surg. 172 68–74 Occurrence Handle10.1016/S0002-9610(96)00049-9 Occurrence Handle1:STN:280:BymA3crgtFM%3D Occurrence Handle8686806

    Article  CAS  PubMed  Google Scholar 

  10. MJ Gil-Egea MT Pi-Sunyer A Verdaguer et al. (1987) ArticleTitleSurgical wound infections: prospective study of 4,468 clean wounds Infect. Control 8 277–280 Occurrence Handle1:STN:280:BiiA3cjhslw%3D Occurrence Handle3650204

    CAS  PubMed  Google Scholar 

  11. RA Garibaldi D Cushing T Lerer (1991) ArticleTitleRisk factors for postoperative infection Am. J. Med. 91 158S–163S Occurrence Handle1:STN:280:By2D38nhslQ%3D

    CAS  Google Scholar 

  12. SF Mishriki DJW Law PJ Jeffery (1990) ArticleTitleFactors affecting the incidence of postoperative wound infection J. Hosp. Infect. 16 223–230 Occurrence Handle1:STN:280:By6D2sbks1U%3D Occurrence Handle1979572

    CAS  PubMed  Google Scholar 

  13. RN Garrison HM Cryer DA Howard et al. (1984) ArticleTitleClarification of risk factors for abdominal operations in patients with hepatic cirrhosis Ann. Surg. 199 648–655 Occurrence Handle1:STN:280:BiuB3s%2FisVA%3D Occurrence Handle6732310

    CAS  PubMed  Google Scholar 

  14. GW Geelhoed K Sharpe GL Simon (1983) ArticleTitleA comparative study of surgical skin preparation methods Surgery 157 265–268 Occurrence Handle1:STN:280:BiyA3c3mtlM%3D

    CAS  Google Scholar 

  15. JA Fairclough D Johnson I Mackie (1986) ArticleTitleThe prevention of wound contamination by skin organisms by the pre-operative application of an iodophor impregnated plastic adhesive drape J. Int. Med. Res. 14 105–109 Occurrence Handle1:STN:280:BimC1MzhtVE%3D Occurrence Handle3699240

    CAS  PubMed  Google Scholar 

  16. PA Dewan AM Rij ParticleVan RG Robinson et al. (1987) ArticleTitleThe use of an iodophor-impregnated plastic incise drape in abdominal surgery: a controlled clinical trial Ann. N. Z. J. Surg. 57 859–863 Occurrence Handle1:STN:280:BieC2cbktlE%3D

    CAS  Google Scholar 

  17. MA Ritter ED Campbell (1988) ArticleTitleRetrospective evaluation of an iodophor-incorporated antimicrobial plastic adhesive wound drape Clin. Orthop. 228 307–308 Occurrence Handle3342583

    PubMed  Google Scholar 

  18. InstitutionalAuthorNameLiver Cancer Study Group of Japan (1990) ArticleTitlePrimary liver cancer in Japan: clinicopathological features and results of surgical treatment Ann. Surg. 211 277–287

    Google Scholar 

  19. H Kinoshita K Sakai K Hirohashi et al. (1986) ArticleTitlePreoperative portal vein embolization for hepatocellular carcinoma World J. Surg. 10 803–808 Occurrence Handle1:STN:280:BiiD2cvjtVE%3D Occurrence Handle3022488

    CAS  PubMed  Google Scholar 

  20. ST Fan ECS Lai CM Lo et al. (1995) ArticleTitleHospital mortality of major hepatectomy for hepatocellular carcinoma associated with cirrhosis Arch. Surg. 130 198–203 Occurrence Handle1:STN:280:ByqC2M%2Fot1U%3D Occurrence Handle7848092

    CAS  PubMed  Google Scholar 

  21. K Takenaka N Kawahara K Yamamoto et al. (1996) ArticleTitleResults of 290 liver resections for hepatocellular carcinoma Arch. Surg. 131 71–76 Occurrence Handle1:STN:280:BymC2c%2FhslA%3D Occurrence Handle8546582

    CAS  PubMed  Google Scholar 

  22. DW Jackson AV Pollock DS Tindal (1971) ArticleTitleThe value of a plastic adhesive drape in the prevention of wound infection: a controlled trial Br. J. Surg. 58 340–342 Occurrence Handle1:STN:280:CS6C1cnmtFI%3D Occurrence Handle4930141

    CAS  PubMed  Google Scholar 

  23. Lilly HA, London PS, Lowbury EJL, et al. Effects of adhesive drapes on contamination of operation wounds. Lancet 1970;431–432

  24. D Raahave (1976) ArticleTitleEffect of plastic skin and wound drapes on the density of bacteria in operation wounds Br. J. Surg. 63 421–426 Occurrence Handle1:STN:280:CSmB3cjis1A%3D Occurrence Handle776325

    CAS  PubMed  Google Scholar 

  25. JW Alexander S Aerni JP Plettner (1985) ArticleTitleDevelopment of a safe and effective one-minute preoperative skin preparation Arch. Surg. 120 1357–1361 Occurrence Handle1:STN:280:BimD2cbot1A%3D Occurrence Handle3904673

    CAS  PubMed  Google Scholar 

  26. DH Johnston JA Fairclough EM Brown et al. (1987) ArticleTitleRate of bacterial recolonization of the skin after preparation: four methods compared Br. J. Surg. 74 64 Occurrence Handle1:STN:280:BiiC2Mfls1Y%3D Occurrence Handle3828740

    CAS  PubMed  Google Scholar 

  27. NJ Espat T Auffenberg A Abouhamze et al. (1996) ArticleTitleA role for tumor necrosis factor-à in the increased mortality associated with Vibrio vulnificus infection in the presence of hepatic dysfunction Ann. Surg. 223 428–433 Occurrence Handle10.1097/00000658-199604000-00012 Occurrence Handle1:STN:280:BymC1cnlvV0%3D Occurrence Handle8633922

    Article  CAS  PubMed  Google Scholar 

  28. K Hiramatsu M Nagino J Kamiya et al. (1998) ArticleTitleA new method to prevent wound infection: a controlled clinical trial in patients with combined liver and bile duct resection Langenbecks Arch. Surg. 383 437–441 Occurrence Handle10.1007/s004230050156 Occurrence Handle1:STN:280:DyaK1M7hvV2itA%3D%3D Occurrence Handle9921943

    Article  CAS  PubMed  Google Scholar 

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Yoshimura, Y., Kubo, S., Hirohashi, K. et al. Plastic Iodophor Drape during Liver SurgeryOperative Use of the Iodophor-impregnated Adhesive Drape to Prevent Wound Infection during High Risk Surgery. World J. Surg. 27, 685–688 (2003). https://doi.org/10.1007/s00268-003-6957-0

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