Wound morbidity in mini-invasive thyroidectomy.
BACKGROUND
The incidence of wound morbidity (WM) after conventional thyroidectomy (CT) is 2 to 7%. This study evaluated the rate of WM after video-assisted thyroidectomy (VAT), with emphasis on surgical-site infections (SSIs).


METHODS
A total of 112 patients were recruited for this prospective, randomized surveillance analysis. The eligibility criteria included nodule smaller than 30 mm, gland volume less than 30 ml, and no previous neck surgery or advanced cancer. The exclusion criteria specified coexistent infection, immunosuppressive treatment, and pathologies requiring antibiotic prophylaxis. The patients were randomized for VAT or CT. Neither antibiotic prophylaxis nor a drain was used. The patients were followed after surgery for WM.


RESULTS
Both groups consisted of 56 patients. The rate for WM was significantly lower in the VAT group (n = 1) than in the CT group (n = 8) (p < 0.05). The incidence of SSI was 5.3% after CT and 0% after VAT (p < 0.05), and the most common pathogenic organism was Staphylococcus aureus. All WMs became evident after patient discharge. Wound infection was associated with prolonged ambulatory dressings.


CONCLUSIONS
No previous studies have compared the rates for WM associated with endoscopic versus open surgery in the cervical area. Wound morbidity was significantly reduced after VAT relative to CT. The authors underscore the important effect of the minor surgical trauma associated with VAT on the development of SSIs.
Dionigi
Gianlorenzo
G
Endocrine Surgery Research Center, Department of Surgical Sciences, University of Insubria, Via Guicciardini, 21100, Varese, Italy. gianlorenzo.dionigi@uninsubria.it
Boni
Luigi
L
Rovera
Francesca
F
Rausei
Stefano
S
Dionigi
Renzo
R
D018249:Adenoma, Oxyphilic / Q000601:surgery; D000328:Adult; D000368:Aged; D016063:Blood Loss, Surgical; D017558:Elective Surgical Procedures; D005260:Female; D006044:Goiter, Nodular / Q000601:surgery; D006801:Humans; D007011:Hypoparathyroidism / Q000453:epidemiology / Q000209:etiology; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D061226:Recurrent Laryngeal Nerve Injuries; D012307:Risk Factors; D013203:Staphylococcal Infections / Q000453:epidemiology / Q000209:etiology; D013530:Surgical Wound Infection / Q000453:epidemiology*; D013964:Thyroid Neoplasms / Q000601:surgery; D013965:Thyroidectomy / Q000009:adverse effects / Q000379:methods*; D020535:Video-Assisted Surgery / Q000009:adverse effects / Q000379:methods*; D055815:Young Adult