eISSN: 1897-4309
ISSN: 1428-2526
Contemporary Oncology/Współczesna Onkologia
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SCImago Journal & Country Rank
3/2018
vol. 22
 
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abstract:
Original paper

The utility of the subcuticular suture in hepatic resection

Yoshihiro Inoue
,
Kensuke Fujii
,
Masatsugu Ishii
,
Syuji Kagota
,
Hiroki Hamamoto
,
Wataru Osumi
,
Yusuke Tsuchimoto
,
Shinsuke Masubuchi
,
Masashi Yamamoto
,
Akira Asai
,
Koji Komeda
,
Shinya Fukunishi
,
Fumitoshi Hirokawa
,
Kazuhide Higuchi
,
Kazuhisa Uchiyama

Contemp Oncol (Pozn) 2018; 22 (3): 184-190
Online publish date: 2018/09/30
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Aim of the study
Despite recent technical progress and advances in the perioperative management of liver surgery, postoperative surgical site infection (SSI) is still one of the most common complications that extends hospital stays and increases medical expenses following hepatic surgery.

Material and methods
From 2001 to 2017 a total of 1180 patients who underwent hepatic resection for liver tumours were retrospectively analysed with respect to the predictive factor of superficial incisional SSI, using a propensity score matching by procedure (subcuticular or mattress suture).

Results
The incidence of superficial and deep incisional SSIs was found to be 7.1% (84/1180). By propensity score matching (PSM), 121 of the 577 subcuticular suture group patients could be matched with 121 of the 603 mattress suture group patients. Multivariate analysis demonstrated wound closure technique as the only independent risk factor that correlated significantly with the occurrence of superficial incisional SSIs (p = 0.038). C-reactive protein (CRP) levels on postoperative day 4 were significantly higher in patients with incisional SSIs than in those without (p < 0.001).

Conclusions
Wound closure technique with subcuticular continuous spiral suture using absorbable suture should be considered to minimise the incidence of incisional SSIs. Moreover, wounds should be carefully checked when CRP levels are high on postoperative day 4.

keywords:

superficial incisional SSI, hepatic resection, subcuticular suture, mattress suture

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