Impact of wound edge protection devices on surgical site infection after laparotomy: multicentre randomised controlled trial (ROSSINI Trial)

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Impact of wound edge protection devices on surgical site infection after laparotomy : multicentre randomised controlled trial (ROSSINI Trial). / West Midlands Research Collaborative; ROSSINI Trial Investigators ; Bach, Simon.

In: British Medical Journal, Vol. 347, No. 7919, f4305, 31.07.2013.

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@article{8cb4bc4eaaf540d8a2a34d599864e2b1,
title = "Impact of wound edge protection devices on surgical site infection after laparotomy: multicentre randomised controlled trial (ROSSINI Trial)",
abstract = "Objective To determine the clinical effectiveness of wound edge protection devices in reducing surgical site infection after abdominal surgery.Design Multicentre observer blinded randomised controlled trial.Participants Patients undergoing laparotomy at 21 UK hospitals.Interventions Standard care or the use of a wound edge protection device during surgery.Main outcome measures Surgical site infection within 30 days of surgery, assessed by blinded clinicians at seven and 30 days and by patient{\textquoteright}s self report for the intervening period. Secondary outcomes included quality of life, duration of stay in hospital, and the effect of characteristics of the patient and operation on the efficacy of the device.Results 760 patients were enrolled with 382 patients assigned to the device group and 378 to the control group. Six patients in the device group and five in the control group did not undergo laparotomy. Fourteen patients, seven in each group, were lost to follow-up. A total of 184 patients experienced surgical site infection within 30 days of surgery, 91/369 (24.7%) in the device group and 93/366 (25.4%) in the control group (odds ratio 0.97, 95% confidence interval 0.69 to 1.36; P=0.85). This lack of benefit was consistent across wound assessments performed by clinicians and those reported by patients and across all secondary outcomes. In the secondary analyses no subgroup could be identified in which there was evidence of clinical benefit associated with use of the device.Conclusions Wound edge protection devices do not reduce the rate of surgical site infection in patients undergoing laparotomy, and therefore their routine use for this role cannot be recommended.Trial registration Current Controlled Trials ISRCTN 40402832",
author = "Thomas Pinkney and Melanie Calvert and Bartlett, {David C} and Adrian Gheorghe and Val Redman and George Dowswell and William Hawkins and Tony Mak and Haney Youssef and Caroline Richardson and Steven Hornby and Laura Magill and Richard Haslop and Sue Wilson and Dion Morton and {West Midlands Research Collaborative} and {ROSSINI Trial Investigators} and Simon Bach",
year = "2013",
month = jul,
day = "31",
doi = "10.1136/bmj.f4305",
language = "English",
volume = "347",
journal = "British Medical Journal",
issn = "0959-8138",
publisher = "BMJ Publishing Group",
number = "7919",

}

RIS

TY - JOUR

T1 - Impact of wound edge protection devices on surgical site infection after laparotomy

T2 - multicentre randomised controlled trial (ROSSINI Trial)

AU - Pinkney, Thomas

AU - Calvert, Melanie

AU - Bartlett, David C

AU - Gheorghe, Adrian

AU - Redman, Val

AU - Dowswell, George

AU - Hawkins, William

AU - Mak, Tony

AU - Youssef, Haney

AU - Richardson, Caroline

AU - Hornby, Steven

AU - Magill, Laura

AU - Haslop, Richard

AU - Wilson, Sue

AU - Morton, Dion

AU - West Midlands Research Collaborative

AU - ROSSINI Trial Investigators

AU - Bach, Simon

PY - 2013/7/31

Y1 - 2013/7/31

N2 - Objective To determine the clinical effectiveness of wound edge protection devices in reducing surgical site infection after abdominal surgery.Design Multicentre observer blinded randomised controlled trial.Participants Patients undergoing laparotomy at 21 UK hospitals.Interventions Standard care or the use of a wound edge protection device during surgery.Main outcome measures Surgical site infection within 30 days of surgery, assessed by blinded clinicians at seven and 30 days and by patient’s self report for the intervening period. Secondary outcomes included quality of life, duration of stay in hospital, and the effect of characteristics of the patient and operation on the efficacy of the device.Results 760 patients were enrolled with 382 patients assigned to the device group and 378 to the control group. Six patients in the device group and five in the control group did not undergo laparotomy. Fourteen patients, seven in each group, were lost to follow-up. A total of 184 patients experienced surgical site infection within 30 days of surgery, 91/369 (24.7%) in the device group and 93/366 (25.4%) in the control group (odds ratio 0.97, 95% confidence interval 0.69 to 1.36; P=0.85). This lack of benefit was consistent across wound assessments performed by clinicians and those reported by patients and across all secondary outcomes. In the secondary analyses no subgroup could be identified in which there was evidence of clinical benefit associated with use of the device.Conclusions Wound edge protection devices do not reduce the rate of surgical site infection in patients undergoing laparotomy, and therefore their routine use for this role cannot be recommended.Trial registration Current Controlled Trials ISRCTN 40402832

AB - Objective To determine the clinical effectiveness of wound edge protection devices in reducing surgical site infection after abdominal surgery.Design Multicentre observer blinded randomised controlled trial.Participants Patients undergoing laparotomy at 21 UK hospitals.Interventions Standard care or the use of a wound edge protection device during surgery.Main outcome measures Surgical site infection within 30 days of surgery, assessed by blinded clinicians at seven and 30 days and by patient’s self report for the intervening period. Secondary outcomes included quality of life, duration of stay in hospital, and the effect of characteristics of the patient and operation on the efficacy of the device.Results 760 patients were enrolled with 382 patients assigned to the device group and 378 to the control group. Six patients in the device group and five in the control group did not undergo laparotomy. Fourteen patients, seven in each group, were lost to follow-up. A total of 184 patients experienced surgical site infection within 30 days of surgery, 91/369 (24.7%) in the device group and 93/366 (25.4%) in the control group (odds ratio 0.97, 95% confidence interval 0.69 to 1.36; P=0.85). This lack of benefit was consistent across wound assessments performed by clinicians and those reported by patients and across all secondary outcomes. In the secondary analyses no subgroup could be identified in which there was evidence of clinical benefit associated with use of the device.Conclusions Wound edge protection devices do not reduce the rate of surgical site infection in patients undergoing laparotomy, and therefore their routine use for this role cannot be recommended.Trial registration Current Controlled Trials ISRCTN 40402832

U2 - 10.1136/bmj.f4305

DO - 10.1136/bmj.f4305

M3 - Article

C2 - 23903454

VL - 347

JO - British Medical Journal

JF - British Medical Journal

SN - 0959-8138

IS - 7919

M1 - f4305

ER -