Aim

To compare the effect of conventional wound dressings (CD) with vitamin E and silicone (E-Sil) dressings on incisional surgical site infection (SSI) in patients undergoing elective colorectal laparoscopic surgery.

Patients and methods

A prospective, randomized study was performed. Patients were assigned at random into two groups: an E-Sil group and a CD group. Incisional SSI, postoperative pain and acute phase reactants were investigated.

Results

In total, 120 patients were included in this study (60 in each group). The incisional SSI rate was 3.4% in the E-Sil group and 17.2% in the CD group (P = 0.013). Bacteroides fragilis alone grew in the cultures of infected wounds in the E-Sil group, while cultures for infected wounds in the CD group were polymicrobial. Mean postoperative pain 48 h after surgery was 27.1 [standard deviation (SD) 10.7] mm in the E-Sil group and 41.6 (SD 16.9) mm in the CD group (P < 0.001). White blood cell (WBC) count and C-reactive protein (CRP) level were lower in the E-Sil group, even after the exclusion of patients presenting with postoperative complications.

Conclusion

Use of an E-sil dressing to cover the Pfannestiel wound after elective laparoscopic colorectal surgery leads to a reduction in the incisional SSI rate, lower postoperative pain, and a decrease in CRP level and WBC count.

中文翻译：

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维生素E和有机硅敷料与常规敷料相比对选择性腹腔镜结直肠手术切口手术部位感染的影响：一项前瞻性随机临床试验

目的

为了比较常规伤口敷料（CD）与维生素E和硅酮（E-Sil）敷料对择期结直肠腹腔镜手术患者的切口手术部位感染（SSI）的影响。

患者和方法

进行了一项前瞻性随机研究。将患者随机分为两组：E-Sil组和CD组。研究了切口SSI，术后疼痛和急性期反应物。

结果

总共120例患者被纳入本研究（每组60例）。E-Sil组的切开SSI率为3.4％，而CD组的切开SSI率为17.2％（P  = 0.013）。E-Sil组的感染伤口培养物中仅生长着脆弱的拟杆菌，而CD组的感染伤口培养物中则是多菌种。E-Sil组术后48 h的平均术后疼痛为27.1 [标准差（SD）10.7] mm，CD组为41.6（SD 16.9）mm（P  <0.001）。即使排除了出现术后并发症的患者，E-Sil组的白细胞（WBC）计数和C反应蛋白（CRP）水平也较低。

结论

选择性腹腔镜结直肠癌手术后使用E-sil敷料覆盖Pfannestiel伤口可导致切开SSI率降低，术后疼痛减轻以及CRP水平和WBC计数降低。