FTP2.6 Topical skin adhesive 2-octylcyanoacrylate dressing reduces the risk of superficial surgical site infections (SSI) in colorectal stoma surgery

Abstract

Abstract Background Superficial surgical site infection is a common morbidity following bowel resection surgery involving stoma formation with clinical and financial implications. The aim of the study was to evaluate the role of topical skin adhesive, 2-octylcyanoacrylate (2-OCA) in reducing wound infections following colorectal stoma surgery. Methods We performed a retrospective, single centre, cohort study using clinical notes. Patients over the age of 18, undergoing bowel resection (elective or emergency) with stoma formation over a period 5 years from January 2015 to December 2019 were included. The primary endpoint was surgical site infection. Patients either received wound dressing with 2- OCA or standard wound dressing. Results 604 patients were included. Median age was 69 (Range 18- 97). 187 (31%) patients received 2-OCA (group 1) and 417 (69%) received standard care (Group 2). 288 (47%) patients were female, 134 (22%) had body mass index > 30, 87 (14%) were diabetic and 90 (15%) were smokers. 279 (46%) patients had ASA score of 3 and 4 (37% vs 50% p=0.0006). 282 (47%) patients went through emergency surgery (34% vs 53% p<0.0001). 279 (64%) patients underwent dirty surgery (17% vs 32% p<0.0001). 220 (35%) patients developed SSI (28% vs 40% p<0.0015). BMI greater than 30 (OR 2.32, p<0.0001), Diabetes (OR 0.54 p<0.0241), dirty surgery (OR 0.43p<0.0001), standard care, no 2-OCA use (OR 1.52 p=0.0343) were associated with SSI. Conclusion Our study demonstrates that there is association between 2-OCA use and reduced SSI in colorectal surgery involving stoma formation when compared to standard methods of wound dressing. Further randomised clinical trial is recommended to demonstrate causation.