Wound protector falls short of reducing infections after pancreatic surgery

Use of an intraoperative wound protector has seemingly failed to provide protection against surgical-site infections (SSIs) after pancreatoduodenectomy, results of a recent trial have shown.

SSIs could lead to higher treatment cost, longer duration of hospital stay, and increased readmission rate after pancreatic surgery, according to the investigators.

To examine the efficacy of a wound protector, patients (n=212) undergoing pancreatoduodenectomy at Verona University Hospital in Italy between 2017 and 2018 were included in this randomized controlled trial. Participants assigned to the experimental group (n=94; 49.5 percent) had a dual-ring wound protector, while those in the control group (n=96; 50.5 percent) had standard surgical drapes.

The two groups were stratified by preoperative biliary stent placement. The overall rate of superficial SSI was the primary outcome.

Following the interim analysis carried out on 212 enrolled patients, 22 (10.4 percent) were excluded due to their inability to complete the pancreatic procedure or their need for postoperative reintervention. No significant between-group differences were observed in demographics as well as in intraoperative findings, pathological data, or surgical outcomes.

A 7.4-percent rate of overall superficial SSI was observed, which did not differ between the experimental and control groups (7 percent vs 7 percent; p=0.585). In a subanalysis of patients with preoperative biliary stent, a similar outcome was also noted between the two treatment arms (9 percent vs 8 percent; p=0.536).

Unfortunately, the trial was terminated early “on the grounds of futility,” according to the investigators.