Evidence map›Paper›PMID 38971699›Full record

ArticleSurgery2024

The effect of damage control laparotomy on surgical-site infection risks after emergent intestinal surgery.

Maosong Ye, Connor P Littlefield, Linder Wendt, Colette Galet, Kevin Huang, Dionne Skeete

Abstract read
In one paragraph

Article in Surgery, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–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

1 citing paper in PubMed.

  1. Article
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

6 authors.

Maosong YeCarver College of Medicine, University of Iowa, Iowa City, IA.
Connor P LittlefieldCarver College of Medicine, University of Iowa, Iowa City, IA.
Linder WendtBiostatistics, Epidemiology, and Research Design Core, Institute for Clinical and Translational Science, University of Iowa, Iowa City, IA.
Colette GaletDivision of Acute Care Surgery, Department of Surgery, University of Iowa, Iowa City, IA. Electronic address: https://twitter.com/ColetteGalet.
Kevin HuangDivision of Acute Care Surgery, Department of Surgery, University of Iowa, Iowa City, IA.
Dionne SkeeteDivision of Acute Care Surgery, Department of Surgery, University of Iowa, Iowa City, IA. Electronic address: dionne-skeete@uiowa.edu.

Funding

University of Iowa Institute for Clinical and Translational ScienceUM1TR004403 · NCATS · UNIVERSITY OF IOWA · PI Marlan R Hansen, Patricia Winokur · 2023 to 2026
$16.1M
NCATS NIH HHS UM1 TR004403
6 · The paper itself

Abstract

introductionDamage-control laparotomy has been widely used in general surgery. However, associated surgical-site infection risks have rarely been investigated. Damage-control laparotomy allows for additional opportunities for decontamination. We hypothesized that damage-control laparotomy would be associated with lower surgical-site infection risks compared with laparotomy with only primary fascial closure or with primary fascial and skin closure.

methodsPatients admitted for emergent intestinal surgery from 2006 to 2021 were included. Multivariate analyses were performed to identify surgical-site infection-associated risk factors. Although variables like laparotomy type (damage-control laparotomy, primary fascial closure, and primary fascial and skin closure) were provided by National Surgical Quality Improvement Program, other variables such as number of operations were retrospectively collected. P < .05 was considered significant.

resultsOverall, 906 patients were included; 213 underwent damage-control laparotomy, 175 primary fascial closure, and 518 primary fascial and skin closure. Superficial, deep, and organ-space surgical-site infection developed in 66, 6, and 97 patients, respectively. Compared with primary fascial and skin closure, both damage-control laparotomy (odds ratio, 0.30 [95% CI, 0.13-0.73], P = .008) and primary fascial closure (odds ratio, 0.09 [95% CI, 0.02-0.37], P = .001) were associated with lower superficial incisional surgical-site infection but not organ-space surgical-site infection risk (odds ratio, 0.80 [95% CI, 0.29-2.19] P = .667 and odds ratio, 0.674 [95% CI, 0.21-2.14], P = .502, respectively). Body mass index was associated with increased risk of superficial incisional surgical-site infection (odds ratio, 1.06 [95% CI, 1.03-1.09], P < .001) whereas frailty was associated with organ space surgical-site infection (odds ratio, 3.28 [95% CI, 1.29-8.36], P = .013). For patients who underwent damage-control laparotomy, the number of operations did not affect risk of either superficial incisional surgical-site infection or organ space SSI.

conclusionHerein, compared with primary fascial and skin closure, both damage-control laparotomy and primary fascial closure were associated with lower superficial but not organ space surgical-site infection risks. For patients who underwent damage-control laparotomy, number of operations did not affect surgical-site infection risks.

Indexed as

LaparotomySurgical Wound InfectionAdultAgedFasciotomyFemaleHumansIntestinesMaleMiddle AgedRetrospective StudiesRisk Factors

Identifiers

PMID38971699
PMCPMC11330352

What OpenQuestion holds

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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.