Evidence map›Paper›PMID 30630087›Full record

Trial reportJournal of the American College of Surgeons2019

Perioperative Bundle to Reduce Surgical Site Infection after Pancreaticoduodenectomy: A Prospective Cohort Study.

Sharon A Lawrence, Caitlin A McIntyre, Alessandra Pulvirenti, Kenneth Seier, Yuting Chou, Mithat Gonen, Vinod P Balachandran, T Peter Kingham, Michael I D'Angelica, Jeffrey A Drebin and 2 more

Abstract readClinical Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Journal of the American College of Surgeons, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
10citing papers in PubMed, 2 pooled it
–field-weighted citation impact
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

10 citing papers in PubMed, 2 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
  3. Review
  4. Article
  5. Article
  6. Review
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  9. Article
  10. Surgical management of biliary malignancy.Current problems in surgery · 2021
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

12 authors.

Sharon A LawrenceDepartment of Surgery, Hepatopancreatobiliary Service, Memorial Sloan Kettering, New York, NY.
Caitlin A McIntyreDepartment of Surgery, Hepatopancreatobiliary Service, Memorial Sloan Kettering, New York, NY.
Alessandra PulvirentiDepartment of Surgery, Hepatopancreatobiliary Service, Memorial Sloan Kettering, New York, NY.
Kenneth SeierDepartment of Epidemiology and Biostatistics, Memorial Sloan Kettering, New York, NY.
Yuting ChouDepartment of Surgery, Hepatopancreatobiliary Service, Memorial Sloan Kettering, New York, NY.
Mithat GonenDepartment of Epidemiology and Biostatistics, Memorial Sloan Kettering, New York, NY.
Vinod P BalachandranDepartment of Surgery, Hepatopancreatobiliary Service, Memorial Sloan Kettering, New York, NY.
T Peter KinghamDepartment of Surgery, Hepatopancreatobiliary Service, Memorial Sloan Kettering, New York, NY.
Michael I D'AngelicaDepartment of Surgery, Hepatopancreatobiliary Service, Memorial Sloan Kettering, New York, NY.
Jeffrey A DrebinDepartment of Surgery, Hepatopancreatobiliary Service, Memorial Sloan Kettering, New York, NY.
William R JarnaginDepartment of Surgery, Hepatopancreatobiliary Service, Memorial Sloan Kettering, New York, NY.
Peter J AllenDepartment of Surgery, Hepatopancreatobiliary Service, Memorial Sloan Kettering, New York, NY. Electronic address: peter.allen@duke.edu.

Funding

X-RAY CRYSTALLOGRAPHYP30CA008748 · NCI · SLOAN-KETTERING INSTITUTE FOR CANCER RES · PI Hongbiao Carl Lekaye · 1985 to 2026
$347.4M
NCI NIH HHS P30 CA008748
6 · The paper itself

Abstract

backgroundPancreaticoduodenectomy is historically associated with incisional surgical site infection (iSSI) rates between 15% and 20%. Prospective studies have been mixed with respect to the benefit of individual interventions directed at decreasing iSSI. We hypothesized that the application of a perioperative bundle during pancreaticoduodenectomy would decrease the rate of iSSIs significantly.

methodsAn initial cohort of 150 consecutive post-pancreaticoduodenectomy patients were assessed within 2 to 4 weeks of operation to determine baseline iSSI rates. The CDC definition of iSSI was used. A 4-part perioperative bundle was then instituted for the second cohort of 150 patients. This bundle consisted of a double-ring wound protector, gown/glove and drape change before fascial closure, irrigation of the wound with bacitracin solution, and a negative-pressure wound dressing that was left in place until postoperative day 7 or day of discharge. Three-hundred patients provided 80% power to detect a 50% risk reduction in iSSIs.

resultsCohorts 1 and 2 were similar with respect to age (68 vs 69 years; p = 0.918), sex (male, 51% vs 55%; p = 0.644), BMI (26 vs 26 kg/m

conclusionsIn this cohort study of 300 consecutive patients who underwent pancreaticoduodenectomy, the implementation of a 4-part bundle decreased iSSI rate from 22% to 11%.

Indexed as

PancreaticoduodenectomyAdultAgedAged, 80 and overCombined Modality TherapyFemaleHumansInfection ControlLogistic ModelsMaleMiddle AgedPatient Care BundlesProspective StudiesSurgical Wound InfectionTreatment Outcome

Identifiers

PMID30630087
PMCPMC8427889

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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.