Unused sterile instruments for closure prevent wound surgical site infection after pancreatic surgery

Background: The incidence of incisional surgical site infection (SSI) after pancreatic surgery remains high. The aim of this study was to assess the effectiveness of the unused sterile instruments that were not used throughout the course of surgery and were opened exactly at the moment of wound closure to prevent incisional SSI after open pancreatic surgery.

Materials and methods: We retrospectively evaluated the incidence of incisional SSI and the clinical course in 203 patients who underwent pancreatic resection in our institution between April 2012 and October 2015.

Results: Twenty-one patients were excluded because they underwent laparoscopic pancreatic surgery; therefore, data from 182 patients were analyzed. Of these, 93 underwent abdominal closure with unused sterile forceps and drape, and 89 did not. The intervention group included 53 pancreaticoduodenectomies, 20 distal pancreatectomies, and 20 underwent other procedures. The control group included 55 pancreaticoduodenectomies, 26 distal pancreatectomies, and eight underwent other procedures. The incidence of incisional SSI in the intervention group (two cases, 2/93, 2.2%) was significantly lower (P = 0.017) compared with that of the control group (11 cases, 11/89, 12.4%). All incisional SSIs in the control group occurred after pancreaticoduodenectomy (11 cases, 11/89, 20.0%). However, none of the pancreaticoduodenectomy patients in the intervention group experienced incisional SSI (P = 0.002).

Conclusions: Unused sterile forceps and drapes during abdominal closure reduced the incidence of incisional SSI after pancreatic surgery, especially pancreaticoduodenectomy.