title: Subcuticular absorbable suture with subcutaneous drainage system prevents incisional SSI after hepatectomy for hepatocellular carcinoma.
abstract: BACKGROUND
  The effectiveness of subcuticular absorbable suture with subcutaneous drainage to decrease the risk of postoperative incisional surgical site infection (SSI) in hepatocellular carcinoma (HCC) patients was evaluated.
  
  
  METHODS
  A total of 149 patients with HCC who underwent hepatectomy (Hx) were retrospectively investigated. Patients were divided into two groups: the patients with subcuticular suture combined with subcutaneous drainage (the drainage group; 61 patients) and the patients with nylon suture without subcutaneous drainage (the nylon group; 88 patients). After the operations, the complication rate of postoperative incisional SSI was analyzed and compared between the two groups.
  
  
  RESULTS
  In the drainage group the rate of incisional SSI was significantly lower compared to the nylon group: 14-3 % (p = 0.033), respectively. Patients with incisional SSI needed significantly longer postoperative hospital care than the patients without incisional SSI: 28 versus 15 days (p < 0.005). Multivariate analysis revealed that subcuticular absorbable suture with subcutaneous drainage significantly reduced the occurrence of incisional SSI (odds ratio; 0.15; p = 0.034).
  
  
  CONCLUSIONS
  We have demonstrated that the subcuticular suture with subcutaneous drainage is effective in preventing incisional SSI in patients undergoing Hx for HCC.
authors.affiliation: Department of Surgery, Hiroshima Red Cross Hospital and Atomic Bomb Survivors Hospital, Hiroshima, 730-8619, Japan. tsujita@hiroshima-med.jrc.or.jp
authors.forename: Eiji
authors.initials: E
authors.lastname: Tsujita
authors.forename: Yo-Ichi
authors.initials: Y
authors.lastname: Yamashita
authors.forename: Kazuki
authors.initials: K
authors.lastname: Takeishi
authors.forename: Ayumi
authors.initials: A
authors.lastname: Matsuyama
authors.forename: Shin-Ichi
authors.initials: S
authors.lastname: Tsutsui
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Matsuda
authors.forename: Akinobu
authors.initials: A
authors.lastname: Taketomi
authors.forename: Ken
authors.initials: K
authors.lastname: Shirabe
authors.forename: Teruyoshi
authors.initials: T
authors.lastname: Ishida
authors.forename: Yoshihiko
authors.initials: Y
authors.lastname: Maehara
mesh_terms: D000042:Absorption; D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000601:surgery*; D004322:Drainage / Q000379:methods*; D005260:Female; D006498:Hepatectomy / Q000009:adverse effects*; D006801:Humans; D008113:Liver Neoplasms / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D013530:Surgical Wound Infection / Q000517:prevention & control*; D013537:Sutures