A Novel Wound Retractor Combining Continuous Irrigation and Barrier Protection Reduces Incisional Contamination and Surgical Site Infection in Colorectal Surgery
Study Details
Study Description
Brief Summary
Surgical site infection (SSI) remains a problem in colorectal surgery. Strategies to reduce the incidence of SSI following colorectal surgery are important to improve overall patient outcomes, reduce healthcare-associated costs and provide value-based healthcare to surgical patients.
Preventing contamination of the wound through the use of barrier wound protectors or intraoperative wound irrigation has shown significant promise individually and is an ongoing focus to reduce wound infections SSI.
| Condition or Disease | Intervention/Treatment | Phase |
|---|---|---|
|
N/A |
Detailed Description
Surgical site infection (SSI) remains a persistent and morbid problem in colorectal surgery with published rates ranging from 7 to 25%. The negative outcomes of SSI are well reported and include a significant increase in morbidity, length of hospital stay, readmissions and healthcare-associated cost. Therefore, strategies to reduce the incidence of SSI following colorectal surgery are important to improve overall patient outcomes, reduce healthcare-associated costs and provide value-based healthcare to surgical patients.
Key to the pathogenesis of SSI is the degree of bacterial contamination of the surgical wound. Preventing contamination of the wound or reducing the bacterial load through the use of barrier wound protectors or intraoperative wound irrigation has shown significant promise individually and is an ongoing strategic focus to reduce wound infections after surgery.
The usage of intraoperative wound irrigation has been shown to significantly reduce the risk of SSI via multiple RTC. A surgical device that combines continuous wound irrigation and barrier protection will have an important SSI prevention advantage.
CleanCision is a recently developed apparatus that serves this purpose and was found to reduce bacterial wound contamination in preclinical and clinical trials.
This study aims to investigate the effect of using CleanCision wound protector on the rates of postoperative Surgical Site Infections in comparison to the current wound protector (Alexis O) being used at our institute.
Study Design
Arms and Interventions
| Arm | Intervention/Treatment |
|---|---|
| Active Comparator: Alexis O Wound Protector Participants will undergo standard surgical procedure using the Alexis O wound protector. |
Device: Alexis O Wound Protector
wound retraction
|
| Experimental: CleanCision Wound Protector Participants will undergo standard surgical procedure using the CleanCision Wound Retraction and Protection System |
Device: CleanCision Wound Retraction and Protection System
wound retraction and irrigation
|
Outcome Measures
Primary Outcome Measures
- Surgical Site Infection rate [30 days]
To evaluate the 30 day post-operative SSI rate in patients undergoing elective colorectal surgical procedures after intraoperative usage of Alexis O wound protector vs. CleanCision continuous irrigation wound protector.
Eligibility Criteria
Criteria
Inclusion Criteria:
-
Patients 18 years old and above.
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Elective colorectal surgery with a planned resection including open or laparoscopic surgeries.
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Clean -contaminated, contaminated and dirty wounds per the definition above.
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Patients undergoing Standard of care SSI reduction bundle including Prophylactic AB and mechanical bowel preparation.
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Anticipated incision length of 3-17 cm
Exclusion Criteria:
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Patients younger than 18 years old.
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Patients with a preexisting stoma.
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Patiens with prior laparotomy within 15 days.
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Patients with an active infection or systemic antibiotic therapy within 1 week prior to surgery with the exception of preoperative antimicrobial prophylaxis.
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Emergent/ urgent surgery.
Contacts and Locations
Locations
| Site | City | State | Country | Postal Code | |
|---|---|---|---|---|---|
| 1 | Cleveland Clinic Foundation | Cleveland | Ohio | United States | 44195 |
Sponsors and Collaborators
- The Cleveland Clinic
Investigators
- Principal Investigator: Scott Steele, MD, The Cleveland Clinic
Study Documents (Full-Text)
None provided.More Information
Publications
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- Solomkin J, Gastmeier P, Bischoff P, Latif A, Berenholtz S, Egger M, Allegranzi B. WHO Guidelines to prevent surgical site infections-Authors' reply. Lancet Infect Dis. 2017 Mar;17(3):262-264. doi: 10.1016/S1473-3099(17)30081-6. Epub 2017 Feb 23.
- Tanner J, Khan D, Aplin C, Ball J, Thomas M, Bankart J. Post-discharge surveillance to identify colorectal surgical site infection rates and related costs. J Hosp Infect. 2009 Jul;72(3):243-50. doi: 10.1016/j.jhin.2009.03.021. Epub 2009 May 15.
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- Wick EC, Vogel JD, Church JM, Remzi F, Fazio VW. Surgical site infections in a "high outlier" institution: are colorectal surgeons to blame? Dis Colon Rectum. 2009 Mar;52(3):374-9. doi: 10.1007/DCR.0b013e31819a5e45.
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