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Wound Infection after Laparoscopic-Assisted Gastrostomy in Infants

Burman, Linnéa ; Diaz, Maia ; Brands Viktorsdóttir, Margrét ; Sjövie, Helen ; Stenström, Pernilla LU ; Salö, Martin LU and Arnbjörnsson, Einar Ólafur LU (2019) In The Surgery Journal 5(3). p.96-102
Abstract

Background  Gastrostomy placement in children is one of the most frequently performed pediatric surgical procedures and laparoscopic-assisted gastrostomy (LAG) is the preferred technique. Wound infection after LAG has become a significant concern due to the emergence of antibiotic resistance. The aim of this study was to describe the frequency of wound infection after LAG in children younger than 2 years of age and to identify the associated risk factors and the bacterial species involved. Methods  Information about wound infection, results from bacterial cultures, and type of antibiotic treatment used within 30 postoperative days after LAG were compiled for infants who underwent LAG from 2010 to 2017. A retrospective chart review was... (More)

Background  Gastrostomy placement in children is one of the most frequently performed pediatric surgical procedures and laparoscopic-assisted gastrostomy (LAG) is the preferred technique. Wound infection after LAG has become a significant concern due to the emergence of antibiotic resistance. The aim of this study was to describe the frequency of wound infection after LAG in children younger than 2 years of age and to identify the associated risk factors and the bacterial species involved. Methods  Information about wound infection, results from bacterial cultures, and type of antibiotic treatment used within 30 postoperative days after LAG were compiled for infants who underwent LAG from 2010 to 2017. A retrospective chart review was performed. Data was compiled from charts and from an electronic database containing prospectively collected data. A multivariate logistic analysis was used to explore potential risk factors. Preoperative antibiotic prophylaxis and postoperative local wound care were conducted according to standard procedures. Results  The 141 included infants underwent surgery at a median age of 10 months (range: 1-24). Thirty-eight (27%) patients had a clinically determined wound infection, bacteria were cultured from 26/38 (69%), and 30/38 (79%) received antibiotic treatment. The median interval from surgery to detection of a clinical wound infection was 14 days (range: 4-30). The most common microbes discovered were skin bacteria Staphylococcus aureus or Streptococcus pyogenes , but respiratory and intestinal bacteria were also found. Multivariate logistic regression analysis revealed no independent risk factors for infection such as age, gender, or underlying diagnosis. Conclusion  Infants have a high rate of postoperative clinical wound infection after LAG despite the use of preoperative antibiotic prophylaxis and intense local wound care. Gender, age at operation, and previous diagnoses were not found to be independent risk factors for wound infection.

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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
The Surgery Journal
volume
5
issue
3
pages
96 - 102
publisher
Georg Thieme Verlag
external identifiers
  • pmid:31508490
ISSN
2378-5128
DOI
10.1055/s-0039-1696731
language
English
LU publication?
yes
id
1c21c15f-2736-4350-ae07-3cf27bb855b7
date added to LUP
2019-09-16 09:13:36
date last changed
2019-09-18 15:26:13
@article{1c21c15f-2736-4350-ae07-3cf27bb855b7,
  abstract     = {<p>Background  Gastrostomy placement in children is one of the most frequently performed pediatric surgical procedures and laparoscopic-assisted gastrostomy (LAG) is the preferred technique. Wound infection after LAG has become a significant concern due to the emergence of antibiotic resistance. The aim of this study was to describe the frequency of wound infection after LAG in children younger than 2 years of age and to identify the associated risk factors and the bacterial species involved. Methods  Information about wound infection, results from bacterial cultures, and type of antibiotic treatment used within 30 postoperative days after LAG were compiled for infants who underwent LAG from 2010 to 2017. A retrospective chart review was performed. Data was compiled from charts and from an electronic database containing prospectively collected data. A multivariate logistic analysis was used to explore potential risk factors. Preoperative antibiotic prophylaxis and postoperative local wound care were conducted according to standard procedures. Results  The 141 included infants underwent surgery at a median age of 10 months (range: 1-24). Thirty-eight (27%) patients had a clinically determined wound infection, bacteria were cultured from 26/38 (69%), and 30/38 (79%) received antibiotic treatment. The median interval from surgery to detection of a clinical wound infection was 14 days (range: 4-30). The most common microbes discovered were skin bacteria Staphylococcus aureus or Streptococcus pyogenes , but respiratory and intestinal bacteria were also found. Multivariate logistic regression analysis revealed no independent risk factors for infection such as age, gender, or underlying diagnosis. Conclusion  Infants have a high rate of postoperative clinical wound infection after LAG despite the use of preoperative antibiotic prophylaxis and intense local wound care. Gender, age at operation, and previous diagnoses were not found to be independent risk factors for wound infection.</p>},
  author       = {Burman, Linnéa and Diaz, Maia and Brands Viktorsdóttir, Margrét and Sjövie, Helen and Stenström, Pernilla and Salö, Martin and Arnbjörnsson, Einar Ólafur},
  issn         = {2378-5128},
  language     = {eng},
  number       = {3},
  pages        = {96--102},
  publisher    = {Georg Thieme Verlag},
  series       = {The Surgery Journal},
  title        = {Wound Infection after Laparoscopic-Assisted Gastrostomy in Infants},
  url          = {http://dx.doi.org/10.1055/s-0039-1696731},
  doi          = {10.1055/s-0039-1696731},
  volume       = {5},
  year         = {2019},
}