USE OF WOUND PROTECTOR FOR PREVENTION OF SURGICAL SITE INFECTION IN LAPAROSCOPIC CHOLECYSTECTOMY

Vadim V. Kryzhevskii; Mykola A. Mendel; Anna P. Brodskaya; Yulia V. Pavlovych

doi:10.31435/rsglobal_ws/31032020/6974

Vadim V. Kryzhevskii Professor, Shupyk National Medical Academy of Postgraduate Education, General and Emergency Surgery Department, Kyiv, Ukraine
Mykola A. Mendel Associate Professor, Shupyk National Medical Academy of Postgraduate Education, General and Emergency Surgery Department, Kyiv, Ukraine; Medical center «Oberig», Kyiv, Ukraine
Anna P. Brodskaya Shupyk National Medical Academy of Postgraduate Education, General and Emergency Surgery Department, Kyiv, Ukraine
Yulia V. Pavlovych Shupyk National Medical Academy of Postgraduate Education, General and Emergency Surgery Department, Kyiv, Ukraine; Medical center «Oberig», Kyiv, Ukraine

DOI: https://doi.org/10.31435/rsglobal_ws/31032020/6974

Keywords: laparoscopic cholecystectomy, surgical site infection, wound protector

Abstract

The work is based on the experience of 759 cholecystectomies performed in 2015-2018. Patients with a 3-4 grades of microbial contamination of wounds were divided into two groups: the first, with removal of the gallbladder traditionally with specimen retrieval container and the second, where proposed method of combined use of container and wound protector was used − 19 patients.
Surgical site infection in laparoscopic cholecystectomy was detected in 5.40% (41 patients out of 759). During surgical interventions related to the second grade of microbial contamination (clean-contaminated), the frequency of SSI was 2.50%, to the third grade (contaminated) − 11.76%, and to the fourth grade (dirty) − 34.92%. Using the proposed method for the simultaneous use of the retrieval container and the double-ring wound protector in the second and third grades of wounds in LC allowed to reduce the frequency of SSI from 37.70% to 5.26%.

References

Comajuncosas J, Hermoso J, Jimeno J, Gris P, Orbeal R, Cruz A, Parés D. Effect of bag extraction to prevent wound infection on umbilical port site wound on elective laparoscopic cholecystectomy: a prospective randomised clinical trial. Surg Endosc. 2017 Jan;31(1):249-254. doi: 10.1007/s00464-016-4965-z.

La Regina D, Mongelli F, Cafarotti S, Saporito A, Ceppi M, Di Giuseppe M, Ferrario di Tor Vajana A. Use of retrieval bag in the prevention of wound infection in elective laparoscopic cholecystectomy: is it evidence-based? A meta-analysis. BMC Surg. 2018 Nov 19;18(1):102. doi: 10.1186/s12893-018-0442-z.

Majid MH, Meshkat B, Kohar H, El Masry S. Specimen retrieval during elective laparoscopic cholecystectomy: is it safe not to use a retrieval bag? BMC Surg. 2016 Sep 19;16(1):64. doi: 10.1186/s12893-016-0181-y.

WHO. Global guidelines on the prevention of surgical site infection, 2016. − http://www.who.int/gpsc/ssi-guidelines/en/#

Profilaktika infekcij oblasti hirurgicheskogo vmeshatel'stva. Klinicheskie rekomendacii. N. Novgorod: Izd- vo «Remedium Privolzh'e», 2018. - 72 p.

Zinn JL. Surgical wound classification: communication is needed for accuracy. AORN J. 2012 Feb;95(2):274-8. doi: 10.1016/j.aorn.2011.10.013.

Patent na korysnu model 136045 Ukrainy, MPK A61B17/00 A61B1/313. Sposib profilaktyky infikuvannia troakarnoi rany pry laparoskopichnykh operatsiiakh: Pat. 136045 Ukrainy, MPK A61B17/00 A61B1/313/ Kryzhevskyi V.V., Mendel M.A., Pavlovych Yu.V., Brodska A.P. - Nou201904147; Zaiavl.18.04.2019; Opubl. 25.07.2019; Biul. No14

Biliaieva O. O., Korzhyk N. P., Myronov O. M., Yemets V. V., Miroshnichenko A. P., Biliaiev V. V. Zhovchnokamiana khvoroba: uskladnennia ta reabilitatsiia. Klinichna khirurhiia. 2014; 11:32-43.