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Fluids & Electrolytes
THURSDAY, Aug. 5 (HealthDay News) -- The use of gentamicin-collagen sponges in patients undergoing colorectal surgery is not an effective method for preventing surgical-site infection, and even appears to increase the risk of infection, according to a study published online Aug. 4 in the New England Journal of Medicine.
In a phase 3 study, Elliott Bennett-Guerrero, M.D., of the Duke University Medical Center in Durham, N.C., and colleagues randomized 602 patients having open or laparoscopically assisted colorectal surgery to undergo insertion of two gentamicin-collagen sponges above the fascia at surgical closure (sponge group) or no intervention (control group), with all patients receiving prophylactic systemic antibiotics.
The researchers found that the surgical-site infection incidence was significantly higher in the sponge group (30 percent) compared to the control group (20.9 percent). Superficial infection at the surgical site occurred in 20.3 percent of patients in the sponge group and 13.6 percent of patients in the control group (P = 0.03), with deep surgical-site infection occurring in 8.3 percent of patients in the sponge group and 6.0 percent of patients in the control group (P = 0.26). In addition, patients in the sponge group were significantly more likely than patients in the control group to visit an emergency department or surgeon's office due to a wound-related symptom or sign (19.7 versus 11 percent).
"In conclusion, our large, multicenter trial shows that the gentamicin-collagen sponge is not effective at preventing surgical site-infection in patients undergoing colorectal surgery and, as compared with the placement of no sponges, appears to result in significantly more surgical site infections," the authors write.
The study was funded by Innocoll Technologies.
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