Juan J Arenal1,3*, John H. Herrera1, Agustín Martínez2, Claudia Tinoco3, César Benito3, Miguel A Citores3, Alejandro Acosta1 and José M Eiros4
1Department of Surgery, Hospital Recoletas Campo Grande, Spain
2Department of Anaesthesia, Hospital Recoletas Campo Grande, Spain
3Department of Surgery, University Hospital Río Hortega, Spain
4Department of Microbiology, University Hospital Río Hortega, Spain
Background: Surgical Site Infection (SSI) remains an important problem in abdominal surgery. The aim of this study is to determine if the use of a wound protection system can be effective in reducing the incidence of wound infection after abdominal surgery.
Methods: Prospective observational study over 409 consecutive patients underwent laparotomy by two surgeons during an eight-year period (2010-2018). A laparotomy auto-retractor was used in all cases (Alexis Wound Retractor; Applied Medical, Rancho Santa Margarita, CA). Ther were151 colorectal resections, 144 appendicectomies, 80 cholecystectomies, 14 gastrectomies and other operations in 20 cases. Preoperative antibiotic prophylaxis was given to all patients. To perform the laparotomy, the skin, subcutaneous tissue, fascia and peritoneum were cut with diathermy. On closing the laparotomy, gloves were changed and no previously used needle holders, forceps, and separators were used. No antibacterial-coated sutures were used for laparotomy closure. The principal variable of the study was wound infection at 30 days, both deep and superficial.
Results: Median age of the series was 58 years (range 14-92). The median Body Mass Index was 24 (range 18-39.5). One hundred and eighty patientes (44%) were operated on an emergency basis. Two hundred and ninety six patients were classified ASA I-II (72%). There were oly four cases of wound infection (1%). The median postoperative stay was four days (range 1-34).
Conclusion: Our results suggest that Alexis wound retractor, is an effective wound edge protector, which contributes to significantly reduce the wound infection rate in abdominal surgery.
Wound infection; Wound edge protector; Double ring retractor; Wound isolation
Arenal JJ, Herrera JH, Mart�nez A, Tinoco C, Benito C, Citores MA, et al. Wound Infection in Abdominal Surgery by Using Double Ring Wall Autoretractor. Clin Surg. 2019; 4: 2421.