Local application of gentamicin collagen implants in the prophylaxis of surgical site infections following gastrointestinal surgery: a review of clinical experience.
BACKGROUND
Surgical site infection (SSI) is a common type of healthcare-associated infection in gastrointestinal (GI) surgical procedures, which often has major consequences for patient recovery and increased healthcare costs due to prolonged hospital stay. This article provides an overview of the efficacy and safety of prophylactic application of resorbable gentamicin-containing collagen implants (GCI) in the prevention of SSI following high-risk GI surgical procedures.


METHODS
Nine publications were identified using the PubMed online database and search terms 'gentamicin collagen implant' plus 'surgical site infection', 'wound infection' and 'gastrointestinal surgery'.


RESULTS
Data from 483 patients treated prophylactically have demonstrated that GCI can reduce the wound infection rate in high-risk GI surgical procedures and improve wound healing after pilonidal sinus excision. In a study of 221 patients who underwent colorectal surgery, the wound infection rate was reduced to 5.6% in the GCI group compared to 18.4% in the control group (P < 0.01). GCI also positively influences the post-operative course for patients undergoing particularly risky procedures e.g. abdominoperineal resection (APR) combined with neoadjuvant radiotherapy. In one such patient series, GCI reduced the wound infection rate by over 70% and the length of hospital stay by 40%. Few side effects of GCI were noted in the 9 clinical studies.


CONCLUSIONS
This review demonstrates that GCI can have a positive effect on wound infection rates in high-risk GI surgery and can also improve wound healing after pilonidal sinus excision.
de Bruin
A F J
AF
Department of Surgery, Division of Colon and Rectal Surgery, Medisch Centrum Rijnmond Zuid, Maasstad Ziekenhuis, Olympiaweg 350, 3078 HT, Rotterdam, The Netherlands. anton_de_bruin@fssoftware.nl
Gosselink
M P
MP
van der Harst
E
E
Rutten
H J T
HJ
D020341:Absorbable Implants; D019072:Antibiotic Prophylaxis / Q000379:methods*; D003094:Collagen; D041981:Gastrointestinal Tract / Q000601:surgery*; D005839:Gentamicins / Q000008:administration & dosage* / Q000009:adverse effects / Q000627:therapeutic use; D006801:Humans; D013530:Surgical Wound Infection / Q000517:prevention & control*
D005839:Gentamicins; D003094:Collagen