Minimally invasive surgical wound infections: laparoscopic surgery decreases morbidity of surgical site infections and decreases the cost of wound care

Colorectal Dis. 2011 Jul;13(7):811-5. doi: 10.1111/j.1463-1318.2010.02302.x. Epub 2010 Apr 29.

Abstract

Aim: The morbidity of surgical site infections (SSIs) were compared in patients who underwent open (OS) vs laparoscopic (LS) colorectal surgery.

Method: Data from 603 consecutive LS patients and 2246 consecutive OS patients were prospectively recorded. Morbidity of SSIs was assessed by the need for emergency department (ED) evaluation, subsequent hospital re-admission and re-operation. The cost of wound care was measured by the need for home healthcare, wound vacuum assisted closure (VAC) or independent patient wound care.

Results: SSIs were identified in 5.8% (n = 25) of LS patients and 4.8% (n = 65) of OS patients. ED evaluation for the infection was needed in 24% of the LS group and 42% of the OS group. Hospital re-admission was needed in one LS patient and in 52% OS patients. No LS patient needed re-operation compared with 12% of OS patients. HHC ($162/dressing change) was required in 63% of the OS group compared with 8% of LS group. A home wound VAC system ($107/day) was utilized in 12% of the OS patients but in none of the LS patients. Dressing changes were managed independently by the patient in 92% of the LS compared with 37% of the OS patients.

Conclusion: Laparoscopic colorectal surgery patients experience less morbidity when they develop SSIs incurring less cost compared with open colorectal surgery patients.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Bandages / economics
  • Colonic Diseases / surgery
  • Emergency Service, Hospital
  • Female
  • Humans
  • Laparoscopy / adverse effects*
  • Laparotomy / adverse effects*
  • Length of Stay
  • Male
  • Middle Aged
  • Morbidity
  • Negative-Pressure Wound Therapy / economics
  • Patient Readmission
  • Rectal Diseases / surgery
  • Reoperation
  • Self Care
  • Surgical Wound Infection / economics*
  • Surgical Wound Infection / epidemiology*