Evidence map›Paper›PMID 29046948›Full record

ArticleLangenbeck's archives of surgery2017

Planned secondary wound closure at the circular stapler insertion site after laparoscopic gastric bypass reduces postoperative morbidity, costs, and hospital stay.

Diana Vetter, Dimitri Aristotle Raptis, Mira Giama, Hanna Hosa, Markus K Muller, Antonio Nocito, Marc Schiesser, Rudolf Moos, Marco Bueter

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Article in Langenbeck's archives of surgery, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
0.6field-weighted citation impact, top 27% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed, 9 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 4 institutions in 1 country.

Diana VetterDepartment of Abdominal and Transplant Surgery, University Hospital of Zurich, Raemistrasse 100, 8091, Zurich, Switzerland.
Dimitri Aristotle RaptisDepartment of Abdominal and Transplant Surgery, University Hospital of Zurich, Raemistrasse 100, 8091, Zurich, Switzerland.
Mira GiamaDepartment of Abdominal and Transplant Surgery, University Hospital of Zurich, Raemistrasse 100, 8091, Zurich, Switzerland.
Hanna HosaDepartment of Abdominal and Transplant Surgery, University Hospital of Zurich, Raemistrasse 100, 8091, Zurich, Switzerland.
Markus K MullerDepartment of Surgery, Cantonal Hospital Frauenfeld, Frauenfeld, Switzerland.
Antonio NocitoDepartment of Surgery, Cantonal Hospital Baden, 5405, Baden, Switzerland.
Marc SchiesserDepartment of Surgery, Cantonal Hospital St. Gallen, St. Gallen, Switzerland.
Rudolf MoosDepartment of Medical Controlling, University Hospital of Zurich, Raemistrasse 100, 8091, Zurich, Switzerland.
Marco BueterDepartment of Abdominal and Transplant Surgery, University Hospital of Zurich, Raemistrasse 100, 8091, Zurich, Switzerland. marco.bueter@usz.ch.
University Hospital of Zurich · CHKantonsspital Baden · CHKantonsspital Frauenfeld · CHUniversity of St.Gallen · CH

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeThe aims of the present study were to assess whether planned secondary wound closure at the insertion site of the circular stapler reduces wound infection rate and postoperative morbidity after laparoscopic Roux-en-Y gastric bypass (RYGB) and to identify independent predictive factors increasing the risk for wound infections after RYGB.

methodsThis paper is a retrospective single-center analysis of a prospectively collected database of 1400 patients undergoing RYGB surgery in circular technique between June 2000 and June 2016. Planned secondary wound closure at the circular stapler introduction site was performed at postoperative day 3 in 291 (20.8%) consecutive patients and compared to a historical control of 1109 (79.2%) consecutive patients with primary wound closure. Independent predictive factors for wound infection were assessed by multivariable analysis.

resultsSecondary wound closure significantly decreased wound infection rate from 9.3% (103/1109) to 1% (3/291) (p < 0.001) leading to a shorter hospital stay (mean 9 (SD8) vs. 7 days (SD2), p < 0.001), lower costs (p = 0.039), and reduced postoperative morbidity (mean 90-day Comprehensive Complication Index (CCI) 7.4 (SD14.0) vs. 5.1 (SD11.1) p = 0.008) when compared to primary wound closure. Primary wound closure, dyslipidemia, and preoperative gastritis were independent predictive risk factors for developing wound infections both in the univariate (p < 0.001; p = 0.048; p = 0.003) and multivariable analysis (p < 0.001; p = 0.040; p = 0.012). Further, on multivariable analysis, the female gender was a predictive factor (p = 0.034) for wound infection development.

conclusionsSecondary wound closure at the circular stapler introduction site in laparoscopic RYGB significantly reduces the overall wound infection rate as well as postoperative morbidity, costs, and hospital stay when compared to primary wound closure.

Indexed as

Health Care CostsSurgical StaplersWound Closure TechniquesAdultFemaleGastric BypassHumansLaparoscopyLength of StayMaleMiddle AgedObesity, MorbidRetrospective StudiesSurgical StaplingSurgical Wound InfectionCircular techniqueGastric bypassSecondary wound closureWound infection

Identifiers

PMID29046948
OpenAlexW2765827567

What OpenQuestion holds

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Read underepoch 390

Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.