title: Effect of Subcutaneous Sterile Vitamin E Ointment on Incisional Surgical Site Infection after Elective Laparoscopic Colorectal Cancer Surgery.
abstract: BACKGROUND
  Despite several interventions having been adopted to reduce the incidence of incisional surgical site infection (SSI), it still remains a challenge for surgeons, because incisional SSI is a common cause of health-care-associated infection, leading to increased morbidity, prolonged hospital stay, patient discomfort, and increased sanitary costs. The aim of this study was to evaluate the effect on incisional SSI of vitamin E ointment in the subcutaneous tissue of patients undergoing a laparoscopic colorectal surgical procedure.
  
  
  METHODS
  A randomized study was performed. Patients with colorectal neoplasms undergoing an elective laparoscopic surgical procedure were included. The patients were randomized into two groups: Those patients undergoing a subcutaneous vitamin E ointment application (Group 1) and those patients who did not receive it (Group 2). Incisional SSI, post-operative pain, and analytical acute phase reactants were analyzed.
  
  
  RESULTS
  There were 108 patients who were assessed for eligibility, and 101 patients were analyzed. The incisional SSI rate was 4% in Group 1 and 17.6% in Group 2 (p = 0.03). Mean post-operative pain, 24 hours after operation, was 17.3 ± 10.5 mm in Group 1 and 31.9 ± 18.9 mm in Group 2 (p < 0.001). Median hospital stay was six days in Group 1 and eight days in Group 2 (p < 0.001). White blood cell count was significantly lower in Group 1 (p < 0.001).
  
  
  CONCLUSIONS
  The subcutaneous application of sterile vitamin E acetate ointment leads to a reduction in the incisional SSI rate, lower post-operative pain, and decrease in C-reactive protein and white blood cell count.
authors.affiliation: Department of Surgery, Coloproctology Unit, University Hospital Rey Juan Carlos , Madrid, Spain .
authors.forename: David
authors.initials: D
authors.lastname: Alias
authors.affiliation: Department of Surgery, Coloproctology Unit, University Hospital Rey Juan Carlos , Madrid, Spain .
authors.forename: Jaime
authors.initials: J
authors.lastname: Ruiz-Tovar
authors.affiliation: Department of Surgery, Coloproctology Unit, University Hospital Rey Juan Carlos , Madrid, Spain .
authors.forename: Ana
authors.initials: A
authors.lastname: Moreno
authors.affiliation: Department of Surgery, Coloproctology Unit, University Hospital Rey Juan Carlos , Madrid, Spain .
authors.forename: Belen
authors.initials: B
authors.lastname: Manso
authors.affiliation: Department of Surgery, Coloproctology Unit, University Hospital Rey Juan Carlos , Madrid, Spain .
authors.forename: Gustavo
authors.initials: G
authors.lastname: Diaz
authors.affiliation: Department of Surgery, Coloproctology Unit, University Hospital Rey Juan Carlos , Madrid, Spain .
authors.forename: Manuel
authors.initials: M
authors.lastname: Duran
authors.affiliation: Department of Surgery, Coloproctology Unit, University Hospital Rey Juan Carlos , Madrid, Spain .
authors.forename: Damian
authors.initials: D
authors.lastname: Garcia-Olmo
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015179:Colorectal Neoplasms / Q000601:surgery*; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009824:Ointments / Q000008:administration & dosage*; D013530:Surgical Wound Infection / Q000517:prevention & control*; D016896:Treatment Outcome; D014810:Vitamin E / Q000008:administration & dosage*; D058106:Wound Closure Techniques
chemical_list: D009824:Ointments; D014810:Vitamin E
keywords: acute phase reactants; incisional surgical site infection; post-operative pain; vitamin E