Dual Ring Wound Protector Reduces Infections in Patients Undergoing Laparoscopic Roux-En-Y Gastric Bypass
By Kerry Young
OXON HILL, Md -- November 4, 2017 -- Infection rates are reduced when a small dual-ring wound protector is used in laparoscopic Roux-en-Y gastric bypass (RYGB) surgery that is performed with a circular stapler, researchers reported here at Obesity Week 2017, the joint Annual Meeting of the American Society for Metabolic & Bariatric Surgery (ASMBS) and The Obesity Society (TOS).
Margaux Miller, University of Utah, Salt Lake City, Utah, and colleagues looked at infection rates seen before and after the April 2016 practice-wide implementation of a new step meant to block spread of bacteria. An XX-small dual ring wound protector is now used at the 15 mm port site during the introduction and removal of the stapler when creating the gastrojejunostomy.
The researchers compared the results for 84 patients treated before the new intervention with the dual ring wound protector with the outcomes of 74 patients who were treated after its implementation.
The surgical site infection rate was 9.5 % in the pre-intervention group and 1.35% in the post-intervention group (P = .037).
The researchers analysed cases that took place between April 15, 2015, and January 31, 2017.
“The numbers we’ve gotten since we submitted the abstract are even better,” reported Miller.
She estimated that the devices cost about $40 each, which she described as a small expense considering the savings possible if a patient avoid an infection and the need for office visits for treatment.
The approach used by the researchers addresses an issue involved with stapling the jejunum, said Miller.
“When you remove it, it has bacteria from the inside, and when you pull it through the port site, you run the risk of it touching the incision site and increasing your chance of infection,” she explained. The wound protector “creates a physical barrier” against infection.
Miller said that further study of this novel approach should be explored, especially as it may be useful in other bariatric surgeries.
[Presentation title: Dual Ring Wound Protector Reduces Circular Stapler Related Surgical Site Infections in Patients Undergoing Laparoscopic Roux-En-Y Gastric Bypass. Abstract A5027]