title: Preperitoneal Continuous Infusion of Local Anesthetics: What Is the Impact on Surgical Wound Infections in Humans?
abstract: Continuous surgical wound infusion with local anesthetics is an effective and widely used technique in postoperative pain management. Some aspects of this technique, however, require further investigation. The aim of this study was to retrospectively assess whether continuous infusion of ropivacaine delays the process of wound healing, with an increased incidence of infection.
  
  
  
  In total, 244 patients aged between 18 and 75 years, American society of anesthesiology II-III, underwent hepatobiliary pancreatic surgery, were classified into two groups and retrospectively analyzed: group R (Ropivacaine) included 152 patients whose surgical incision was fitted with a preperitoneal catheter continuously infusing ropivacaine. Group C (Control) included 92 patients receiving a total intravenous postoperative analgesia. The evaluation forms of the surgical wound according to the Southampton wound assessment scale (SWAS) were collected at three time points. The main outcome was the rate of patients with surgical site infection within 30 days postoperatively.
  
  
  
  Twenty-one patients (13.8%) in group R and 9 patients (9.8%) in group C (P = 0.35) presented wound infection. The rate of patients with a wound evaluation of a SWAS grade IV or V in three time frames in Group R and Group C was T0, 1 (0.7%) and 1 (1.08%) (P = 0.72); T1, 25 (16.4%) and 7 (7.6%) (P = 0.04); T2, 8 (5.3%) and 5 (5.4%) (P = 0.53), respectively.onclusions. The incidence of infection in the surgical site according to the centers for disease control definition was comparable in both groups. The description of the wound healing process according to the SWAS scale shows an initial and temporary decrease in maturation in group R which does not persist in the long-term.
authors.affiliation: Departments of *Anaesthesiology clacla@fastwebnet.it.
authors.forename: Claudia
authors.initials: C
authors.lastname: Claroni
authors.affiliation: Departments of *Anaesthesiology.
authors.forename: Maria Elena
authors.initials: ME
authors.lastname: Marcelli
authors.affiliation: Departments of *Anaesthesiology.
authors.forename: Maria Carla
authors.initials: MC
authors.lastname: Sofra
authors.affiliation: Departments of *Anaesthesiology.
authors.forename: Marco
authors.initials: M
authors.lastname: Covotta
authors.affiliation: Departments of *Anaesthesiology.
authors.forename: Giulia
authors.initials: G
authors.lastname: Torregiani
authors.affiliation: Biostatistics, Regina Elena National Cancer Institute, Rome, Italy.
authors.forename: Diana
authors.initials: D
authors.lastname: Giannarelli
authors.affiliation: Departments of *Anaesthesiology.
authors.forename: Ester
authors.initials: E
authors.lastname: Forastiere
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D016058:Analgesia, Patient-Controlled / Q000379:methods*; D000779:Anesthetics, Local / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D007263:Infusions, Parenteral / Q000379:methods*; D008297:Male; D008875:Middle Aged; D010149:Postoperative Pain / Q000175:diagnosis / Q000188:drug therapy*; D012189:Retrospective Studies; D000072836:Surgical Wound / Q000175:diagnosis / Q000188:drug therapy*; D055815:Young Adult
chemical_list: D000779:Anesthetics, Local
keywords: Local Anesthetics; Local); Postoperative Pain; Ropivacaine (Anesthetics; Wound Infection