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Reduction of wound infections in laparoscopic-assisted colorectal resections by plastic wound ring drapes (REDWIL)?—a randomized controlled trial

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Abstract

Introduction

Surgical site infections (SSIs) are frequent complications in colorectal surgery and may lead to burst abdomen, incisional hernia, and increased perioperative costs. Plastic wound ring drapes (RD) were introduced some decades ago to protect the abdominal wound from bacteria and reduce SSIs. There have been no controlled trials examining the benefit of RD in laparoscopic colorectal surgery. The Reduction of wound infections in laparoscopic assisted colorectal resections by plastic wound ring drapes (REDWIL) trial was thus designed to assess their effectiveness in preventing SSIs after elective laparoscopic colorectal resections.

Materials/methods

REDWIL is a randomized controlled monocenter trial with two parallel groups (experimental group with RD and control group without RD). Patients undergoing elective laparoscopic colorectal resection were included. The primary endpoint was SSIs. Secondary outcomes were colonization of the abdominal wall with bacteria, reoperations/readmissions, early/late postoperative complications, and cost of hospital stay. The duration of follow-up was 6 months.

Results

Between January 2008 and October 2010, 109 patients were randomly assigned to the experimental or control group (with or without RD). Forty-six patients in the RD group and 47 patients in the control group completed follow-up. SSIs developed in ten patients with RD (21.7 %) and six patients without RD (12.8 %) (p = 0.28). An intraoperative swab taken from the abdominal wall was positive in 66.7 % of patients with RD and 57.5 % without RD (p = 0.46). The number of species cultured within one swab was significantly higher in those without RD (p = 0.03). The median total inpatient costs including emergency readmissions were 3,402 ± 4,038 € in the RD group and 3,563 ± 1,735 € in the control group (p = 0.869).

Conclusions

RD do not reduce the rate of SSIs in laparoscopic colorectal surgery. The inpatient costs are similar with and without RD.

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Authors and Affiliations

  1. Department of General, Vascular, and Thoracic Surgery, Charité Campus Benjamin Franklin, Hindenburgdamm 30, 12200, Berlin, Germany

    J. C. Lauscher, M. Zimmermann & H. J. Buhr

  2. Faculty of Medicine, Charité Campus Mitte, Charitéplatz 1, 10117, Berlin, Germany

    F. Grittner

  3. Institute of Biometry and Clinical Epidemiology, Charité Campus Mitte, Charitéplatz 1, 10098, Berlin, Germany

    A. Stroux

  4. Division of Medical Quality Assurance, Charité Campus Mitte, Charitéplatz 1, 10117, Berlin, Germany

    M. le Claire

  5. Department of General and Visceral Surgery, HELIOS Kliniken Schwerin, Wismarsche Straße 393-397, 19049, Schwerin, Germany

    J. P. Ritz

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  1. J. C. Lauscher
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  2. F. Grittner
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  3. A. Stroux
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  4. M. Zimmermann
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  5. M. le Claire
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  6. H. J. Buhr
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  7. J. P. Ritz
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Correspondence to J. C. Lauscher.

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Lauscher, J.C., Grittner, F., Stroux, A. et al. Reduction of wound infections in laparoscopic-assisted colorectal resections by plastic wound ring drapes (REDWIL)?—a randomized controlled trial. Langenbecks Arch Surg 397, 1079–1085 (2012). https://doi.org/10.1007/s00423-012-0954-4

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  • DOI: https://doi.org/10.1007/s00423-012-0954-4

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