title: Minimally invasive surgical wound infections: laparoscopic surgery decreases morbidity of surgical site infections and decreases the cost of wound care.
abstract: OBJECTIVE
  The morbidity of surgical site infections (SSIs) were compared in patients who underwent open (OS) vs laparoscopic (LS) colorectal surgery.
  
  
  METHODS
  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.
  
  
  CONCLUSIONS
  Laparoscopic colorectal surgery patients experience less morbidity when they develop SSIs incurring less cost compared with open colorectal surgery patients.
authors.affiliation: The Department of Colon and Rectal Surgery, The Cleveland Clinic Foundation, Cleveland, Ohio, USA. mdobsondo@hotmail.com
authors.forename: M W
authors.initials: MW
authors.lastname: Dobson
authors.forename: D
authors.initials: D
authors.lastname: Geisler
authors.forename: V
authors.initials: V
authors.lastname: Fazio
authors.forename: F
authors.initials: F
authors.lastname: Remzi
authors.forename: T
authors.initials: T
authors.lastname: Hull
authors.forename: J
authors.initials: J
authors.lastname: Vogel
mesh_terms: D000328:Adult; D001458:Bandages / Q000191:economics; D003108:Colonic Diseases / Q000601:surgery; D004636:Emergency Service, Hospital; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects*; D007813:Laparotomy / Q000009:adverse effects*; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D009017:Morbidity; D054843:Negative-Pressure Wound Therapy / Q000191:economics; D010359:Patient Readmission; D012002:Rectal Diseases / Q000601:surgery; D012086:Reoperation; D012648:Self Care; D013530:Surgical Wound Infection / Q000191:economics* / Q000453:epidemiology*