Local application of gentamicin-containing collagen implant in the prophylaxis of surgical site infection following gastrointestinal surgery.
BACKGROUND
Gastrointestinal surgery is associated with one of the highest rates of SSI due to the nature of the surgery and to the added complication of operating on patients with significant co-morbidities. This high rate of SSI may negatively impact wound healing, patient recovery time, length of hospital stay and associated healthcare costs. This article provides an overview of the efficacy and safety of prophylactic application of resorbable gentamicin-containing collagen implants (GCCI) in the prevention of SSI following GI surgical procedures.


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


RESULTS
Eleven out of 13 studies have demonstrated that prophylactic use of GCCI can reduce the wound infection rate in high-risk GI surgical procedures (e.g. abdominoperineal resection [APR]) and improve wound healing after pilonidal sinus excision. GCCI may also have a role to play in preventing anastomotic leakage following mesorectal excision for rectal carcinoma. It is recommended that GCCI are used dry in line with the manufacturer's recommendations.


CONCLUSIONS
This review demonstrates that GCCI can significantly reduce surgical site infection following GI surgery including pilonidal sinus excision and high-risk procedures such as APR.
Department of Colorectal Surgery, Maastad Hospital, Rotterdam, The Netherlands. anton_de_bruin@hotmail.com
Anton F J
AF
de Bruin
Martijn P
MP
Gosselink
Erwin
E
van der Harst
D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D019072:Antibiotic Prophylaxis / Q000379:methods; D015331:Cohort Studies; D024042:Collagen Type I / Q000008:administration & dosage*; D013505:Digestive System Surgical Procedures / Q000379:methods*; D004343:Drug Implants; D005839:Gentamicins / Q000008:administration & dosage*; D006801:Humans; D013530:Surgical Wound Infection / Q000188:drug therapy / Q000517:prevention & control / Q000628:therapy*
D000900:Anti-Bacterial Agents; D024042:Collagen Type I; D004343:Drug Implants; D005839:Gentamicins