Surgical site infection (SSI) is a common occurrence among patients who have had gastrointestinal surgery, with reported infection rates varying from 4 to 25 percent. A meta-analysis study published this month in Surgical Endoscopy shows that wound protector use is associated with a statistically significant reduction in SSI in patients undergoing lower gastrointestinal surgery (OR 0.64, P<0.01).1 The study further shows that there is a 63 percent decrease in SSI risk when using dual-ring wound protectors compared to using single-ring wound protectors.2 This is the only published meta-analysis that focuses primarily on wound protectors in lower GI surgery.
Study Design: The study consisted of 12 randomized controlled trials with 3,029 participants. EMBASE (1947-2016) and MEDLINE (1946-2016) databases were searched on August 4, 2016. References cited in related reviews and included trials were examined for additional studies that fit the inclusion criteria.
About SSI:As referenced in the study, SSIs account for 20 percent of hospital-acquired infections, resulting in approximately $3.5 billion to $10 billion annually in healthcare expenditures. The study’s data analysis suggests that the use of dual-ring wound protectors should be considered in open lower gastrointestinal surgery.
About the Alexis® Wound Protector/Retractor:Developed and manufactured by Applied Medical, the Alexis wound protector/retractor features a dual-ring design in a wide range of sizes for use within multiple specialties. The Alexis wound protector/retractor features 360-degree protection to help reduce surgical site infection,3-7 shield incision sites from bacterial invasion8-9 and maintain moisture to promote healing.10
“At Applied Medical, it’s our mission to enhance clinical care and improve patient outcomes. We work in partnership with our customers to help reduce surgical site infections through our products and programs,” said Serene Wachli, president of Horizon II Division at Applied Medical. “We’re proud to provide our dual-ring Alexis wound protector/retractor to hospitals worldwide to help meet clinical needs.”
- Zhang L, Elsolh B, Patel SV. Wound protectors in reducing surgical site infections in lower gastrointestinal surgery: An updated meta-analysis. Surg Endosc. 2018;32(3):1111-1122. (Level of Evidence 1)
- The comparison of dual-ring wound protectors (OR 0.31, P<0.0001) to single-ring wound protectors (OR 0.84, P=0.11) is statistically significant (P=0.01).
- Reid K, Pockney P, Draganic B, Smith SR. Barrier wound protection decreases surgical site infection in open elective colorectal surgery: A randomized clinical trial. Dis Colon Rectum. 2010;53(10):1374-1380. (Level of Evidence 1)
- Cheng KP, Roslani AC, Sehha N, et al. ALEXIS O-Ring wound retractor vs conventional wound protection for the prevention of surgical site infections in colorectal resections. Colorectal Dis. 2012;14(6):e346-e351. (Level of Evidence 1)
- Lee P, Waxman K, Taylor B, Yim S. Use of wound-protection system and postoperative wound-infection rates in open appendectomy: A randomized prospective trial. Arch Surg. 2009;144(9):872- 875. (Level of Evidence 1)
- Horiuchi T, Tanishima H, Tamagawa K, et al. Randomized, controlled investigation of the anti-infective properties of the Alexis retractor/protector of incision sites. J Trauma. 2007;62(1):212-215. (Level of Evidence 1)
- Hinkson L, Siedentopf J-P, Weichert A, Henrich W. Surgical site infection in cesarean sections with the use of a plastic sheath wound retractor compared to the traditional self-retaining metal retractor. Eur J Obstet Gynecol Reprod Biol. 2016;203:232-238. (Level of Evidence 1)
- Mohan HM, McDermott S, Fenelon L, et al; Members of the University College Dublin Wound Retractor Study Group. Plastic wound retractors as bacteriological barriers in gastrointestinal surgery: A prospective multi-institutional trial. J Hosp Infect. 2012;81(2):109-113. (Level of Evidence 2)
- Horiuchi T, Tanishima H, Tamagawa K, et al. A wound protector shields incision sites from bacterial invasion. Surg Infect (Larchmt). 2010;11(6):501-503. (Level of Evidence 4)
- Horiuchi T, Nakatsuka S, Tanishima H, et al. A wound retractor/protector can prevent infection by keeping tissue moist and preventing tissue damage at incision sites. Helix Review Series: Infectious Diseases. 2007;(3):17-23. (Level of Evidence 5)