期刊
JOURNAL OF PEDIATRIC SURGERY
卷 57, 期 6, 页码 1145-1148出版社
W B SAUNDERS CO-ELSEVIER INC
DOI: 10.1016/j.jpedsurg.2022.01.043
关键词
Gastrostomy tube; Laparoscopic gastrostomy tube; Laparoscopic gastrostomy tube placement; Surgical site infection; Laparoscopic surgery; Pediatric
The use of absorbable braided and long-lasting monofilament transabdominal tacking sutures may increase the risk of surgical site infection (SSI) following modified laparoscopic gastrostomy tube placement. In this study, the use of poliglecaprone suture was associated with no SSIs and similar rates of postoperative dislodgement, leakage, and granulation tissue.
Background: Laparoscopic gastrostomy tube (GT) placement carries the risk of early tube dislodgement and is often modified with absorbable subcutaneously-tunneled transabdominal tacking sutures that can aid in tube replacement. However, these buried sutures may increase the risk of surgical site infection (SSI). This study sought to evaluate SSI rates associated with different types of transabdominal tacking sutures used in modified laparoscopic GT placement. Methods: A single-institution, retrospective review was performed of all patients <= 18 years-old undergoing modified laparoscopic GT placement between September 2016 and March 2020. Patients were stratified into three groups by suture type used, and the primary outcome was SSI within six weeks of surgery. Demographic and perioperative data were analyzed by chi-square or Fisher's exact test. Results: A total of 113 modified laparoscopic GT placements were performed at a median age of 9 months (interquartile range 3 months to 3 years). Prophylactic antibiotic use was similar between groups. Eleven patients (10%) developed an SSI, and all were treated with antibiotics alone. No SSIs were observed with the use of poliglecaprone suture (n = 46), and higher SSI rates were observed with use of polyglactin (n = 17) and polydioxanone (n = 51) suture (18% polyglactin vs. 16% polydioxanone vs. 0% poliglecaprone, p < 0.05). No differences were observed in rates of early postoperative dislodgement, leakage, or granulation tissue. Conclusion: Absorbable braided and long-lasting monofilament transabdominal tacking sutures may increase risk of SSI following modified laparoscopic gastrostomy tube placement. In this cohort, the use of poliglecaprone (Monocryl) suture was associated with no SSIs and similar rates of postoperative dislodgement, leakage, and granulation tissue. Published by Elsevier Inc.
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