Abstract
The aim of this randomized control study was to evaluate the effectiveness and safety of endoscopy for the treatment of surgical site infection (SSI), compared with conventional therapy. One hundred and six patients who were diagnosed with severe SSI were included in the study, performed from May 2005 to July 2012 at Tianjin Binhai New Area Dagang Hospital, China. Patients were randomly divided into two groups: 57 patients in group A treated by endoscopy and 49 patients in group B treated by conventional therapy for SSI. The primary outcome was the healing period of the wound; the secondary outcomes were the blood loss following surgery, visual analog scale (VAS) measurement, volume of irrigation saline during surgery, rate of skin transplantation, length of hospital stay and other complications. The mean wound healing time was significantly less in group A (10.0±2.5 days) than in group B (19.4±5.2 days). The mean VAS score 7 days after surgery in group A was significantly less compared with group B. The intra-operative blood loss, intra-operative volume of irrigation saline and length of the hospital stay were significantly reduced in group A compared with group B. No significant differences between the groups were revealed in terms of the duration of surgery and the clinical complications. This study demonstrated that the endoscopy procedure for the treatment of SSI reduces the wound healing time compared with that of traditional surgery, without increasing any risk of clinical events. The present study showed that endoscopy was not only effective but also safe in the therapy of serious SSI. However, a further randomized control trial is necessary to testify our conclusions.
Highlights
Infections that occur in the wound created by an invasive surgical procedure are generally referred to as surgical site infections (SSIs)
Prevalence studies tend to underestimate SSI, since the majority of these infections occur after the patient has been discharged from hospital
Patients in group A had a mean intra‐operative blood loss of 327±89 ml, which was significantly reduced [mean difference (MD), ‐78.00; 95% CI, ‐132.68 to ‐23.32; P=0.005] when compared with that of group B (405±177 ml)
Summary
Infections that occur in the wound created by an invasive surgical procedure are generally referred to as surgical site infections (SSIs). SSI is one of the most significant causes of healthcare‐associated infection, and may prolong hospitalization by 5‐20 days and substantially increase the cost of healthcare [3,4]. It is associated with substantial morbidity and it has been reported that over one‐third of postoperative mortality is associated, at least in part, with serious SSI [5]. Prevalence studies tend to underestimate SSI, since the majority of these infections occur after the patient has been discharged from hospital. Other complications of SSI include scars that are cosmetically unacceptable, such as keloid scars, itching, persistent pain and a significant impact on emotional wellbeing [6]
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