title: Efficacy of skin closure with subcuticular sutures for preventing wound infection after resection of colorectal cancer: a propensity score-matched analysis.
abstract: OBJECTIVE
  The purpose of this study was to examine the efficacy of skin closure with subcuticular sutures for the prevention of wound infection after colorectal cancer resection.
  
  
  METHODS
  Medical records of 1008 patients with colorectal cancer who underwent resection between 2006 and 2013 were reviewed. Patients were divided into two groups based on skin closure method: the subcuticular suture group (n = 323) and the staple group (n = 685). The incidence of wound infection was compared with and without propensity score matching, and multivariate analysis was performed to identify risk factors for wound infection.
  
  
  RESULTS
  The incidence of wound infection was 3.1 % (10/323) in the subcuticular suture group and 10.4 % (71/685) in the staple group. After propensity score matching, the incidence of wound infection was significantly lower in the subcuticular suture group (4.6 %, 9/197) than in the staple group (12.2 %, 24/197) (p = 0.004). In the propensity score-matched cohort, multivariate analysis identified advanced age (odds ratio [OR], 1.07; 95 % confidence interval [CI], 1.03-1.12), higher preoperative body mass index (OR, 1.19; 95 % CI, 1.07-1.33), lower preoperative serum albumin (OR, 0.45; 95 % CI, 0.22-0.91), open surgery (OR, 3.28; 95 % CI, 1.38-8.49), and skin closure with staples (OR, 3.21; 95 % CI, 1.43-7.81) as independent risk factors for wound infection.
  
  
  CONCLUSIONS
  Our results suggest that subcuticular suturing could be beneficial after colorectal cancer surgery.
authors.affiliation: Department of Surgery, National Hospital Organization, Osaka National Hospital, 2-1-14 Hoenzaka, Chuo-ku, Osaka, 540-0006, Japan.
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Yamaoka
authors.affiliation: Department of Surgery, National Hospital Organization, Osaka National Hospital, 2-1-14 Hoenzaka, Chuo-ku, Osaka, 540-0006, Japan. mikeda@onh.go.jp.
authors.forename: Masataka
authors.initials: M
authors.lastname: Ikeda
authors.affiliation: Department of Surgery, Higashiosaka City General Hospital, 3-4-5 Nishiiwata, Higashiosaka, Osaka, 591-8025, Japan.
authors.forename: Masakazu
authors.initials: M
authors.lastname: Ikenaga
authors.affiliation: Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan.
authors.forename: Naotsugu
authors.initials: N
authors.lastname: Haraguchi
authors.affiliation: Department of Surgery, National Hospital Organization, Osaka National Hospital, 2-1-14 Hoenzaka, Chuo-ku, Osaka, 540-0006, Japan.
authors.forename: Masakazu
authors.initials: M
authors.lastname: Miyake
authors.affiliation: Department of Surgery, National Hospital Organization, Osaka National Hospital, 2-1-14 Hoenzaka, Chuo-ku, Osaka, 540-0006, Japan.
authors.forename: Kazuyoshi
authors.initials: K
authors.lastname: Yamamoto
authors.affiliation: Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan.
authors.forename: Tadafumi
authors.initials: T
authors.lastname: Asaoka
authors.affiliation: Department of Surgery, National Hospital Organization, Osaka National Hospital, 2-1-14 Hoenzaka, Chuo-ku, Osaka, 540-0006, Japan.
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Nishikawa
authors.affiliation: Department of Surgery, National Hospital Organization, Osaka National Hospital, 2-1-14 Hoenzaka, Chuo-ku, Osaka, 540-0006, Japan.
authors.forename: Atsushi
authors.initials: A
authors.lastname: Miyamoto
authors.affiliation: Department of Surgery, National Hospital Organization, Osaka National Hospital, 2-1-14 Hoenzaka, Chuo-ku, Osaka, 540-0006, Japan.
authors.forename: Michihiko
authors.initials: M
authors.lastname: Miyazaki
authors.affiliation: Department of Surgery, National Hospital Organization, Osaka National Hospital, 2-1-14 Hoenzaka, Chuo-ku, Osaka, 540-0006, Japan.
authors.forename: Motohiro
authors.initials: M
authors.lastname: Hirao
authors.affiliation: Department of Surgery, National Hospital Organization, Osaka National Hospital, 2-1-14 Hoenzaka, Chuo-ku, Osaka, 540-0006, Japan.
authors.forename: Shoji
authors.initials: S
authors.lastname: Nakamori
authors.affiliation: Department of Surgery, National Hospital Organization, Osaka National Hospital, 2-1-14 Hoenzaka, Chuo-ku, Osaka, 540-0006, Japan.
authors.forename: Mitsugu
authors.initials: M
authors.lastname: Sekimoto
mesh_terms: D000368:Aged; D015179:Colorectal Neoplasms / Q000601:surgery*; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D057216:Propensity Score; D012307:Risk Factors; D013530:Surgical Wound Infection / Q000453:epidemiology / Q000517:prevention & control*; D013536:Suture Techniques; D016896:Treatment Outcome
keywords: Colorectal surgery; Propensity score–matched analysis; Risk factor; Staples; Subcuticular sutures; Wound infection