Effect of wound-protector use on surgical site infections post-pancreatic surgery: NSQIP study

Abstract

There is currently no published data on their role in pancreatic surgery. We aim to assess the effect of using wound protectors on the rate of surgical site infections (SSI) post-pancreatic surgery. The American College of Surgeons - National Surgical Quality Improvement Program Database 2016 was queried for distal pancreatectomy (DP) or pancreatoduodenectomy (PD) patients. The incidence of surgical site infections (SSI): superficial, deep and organ-space; were compared by use or not of wound protectors. A total of 4797 patients were included in the study. Among them, 22.6% (n = 1085) and 77.4% (n = 3712) patients underwent DP and PD, respectively. The SSIs rates were 6.7% (n = 323), 0.8% (n = 39) and 15.3% (n = 734) respectively superficial, deep and organ-space SSIs. The SSIs rates for cases in which a wound protector was used and not used were: 5.1% (n = 55) and 7.2% (n = 268) for superficial SSIs (P = 0.018), 0.7% (n = 8) and 0.8% (n = 31) for deep SSIs (P = 0.79); and 13.6% (n = 145) and 15.8% (n = 589) organ-space SSIs (P = 0.07), respectively. The use of wound protector did not significantly change the rate of SSIs in patients who underwent DP. However, a significant change in the rate of superficial SSI by noted in PD patients; 5.6% (n = 50) and 8.1% (n = 229), P = 0.015. The use of a wound protector was associated with a decrease in the rate of superficial SSIs following pancreatoduodenectomy patients but not distal pancreatectomy. As such, the use of a wound protector should be considered a part of a package to reduce SSIs in patients undergoing pancreatic surgery, and in particular PD.