Journal Review in Emergency General Surgery: Surgical Site Complications

EP. 543Nov. 14, 202225:25
Emergency General Surgery
Emergency General Surgery
The dreaded Surgical Site Complications! Join Drs. Ashlie Nadler, Jordan Nantais and Graham Skelhorne-Gross from our Emergency General Surgery Team as they discuss surgical site complications and prevention techniques.

Paper 1: Arnold et. al. (2019) Not a Routine Case, Why Expect the Routine Outcome? Quantifying the Infectious Burden of Emergency General Surgery Using the NSQIP. American Surgeon 

- NSQIP database 2005-2016 (>800,000 patients) including open/laparoscopic cholecystectomies, ventral hernia repairs, and partial colectomies 
- Comparing outcomes in emergent vs elective cases
- Primary outcome: aggregate of SSIs which includes wound disruption, superficial SSI, deep SSI, and organ space SSI 
- Results:
-- ?SSI in the emergency group (5.3% vs 3.6%) 
-- When controlling for multiple variables, emergency surgery associated with more SSIs (OR 1.15).  

Paper 2: Lakhani et. al. (2022) Prophylactic negative pressure wound dressings reduces wound complications following emergency laparotomies: A systematic review and meta-analysis. Surgery 

- NPWD remove excess fluid from subcutaneous space, ? collections/contaminants, promote angiogenesis, fibroblast infiltration  
- Literature review 2005-2022 (NPWD, laparotomy, SSI) 
- 1199 patients included (566 NPWD, 633 standard dressings) 
- Results:
-- NPWD ? wound infection (OR 0.43) and wound breakdown (OR 0.36) 
-- No change in LOS, readmission

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