{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,6]],"date-time":"2025-11-06T12:14:55Z","timestamp":1762431295095},"reference-count":36,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2017,6,12]],"date-time":"2017-06-12T00:00:00Z","timestamp":1497225600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2017,6,12]],"date-time":"2017-06-12T00:00:00Z","timestamp":1497225600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/www.springer.com\/tdm"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["World j. surg."],"published-print":{"date-parts":[[2017,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>The objective of this study was to evaluate the benefits of wound protectors (WPs) in preventing incisional surgical site infection (I\u2010SSI) in open elective digestive surgery using data from a large\u2010scale, multi\u2010institutional cohort study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Patients who had elective digestive surgery for malignant neoplasms between November 2009 and February 2011 were included. The protective value of WPs against I\u2010SSI was evaluated.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 3201 patients were analyzed. A WP was used in 1022 patients (32%). The incident rate of I\u2010SSI (not including organ\/space SSI) was 9%. In the univariate and the multivariate analyses for perioperative risk factors for I\u2010SSI, the use of WP was an independent favorable factor that reduced the incidence of I\u2010SSI (odds ratio 0.73, 95% confidence interval 0.55\u20130.98. <jats:italic>P<\/jats:italic> = 0.038). The subgroup forest plot analyses revealed that WP reduced the risk of I\u2010SSI only in patients aged 74 years or younger, males, non\u2010obese patients (body mass index &lt;25\u00a0kg\/m<jats:sup>2<\/jats:sup>), patients with an American Society of Anesthesiologists score of 1\/2, patients with a previous history of laparotomy, non\u2010smokers, and patients who underwent colon and rectum operations. In patients who underwent colorectal surgery, the postoperative hospital stay was significantly shorter in patients with WP than those without WP (median 13 vs. 15\u00a0days, <jats:italic>P<\/jats:italic> = 0.040). In terms of the depth of SSI, WP only prevented superficial I\u2010SSI and did not reduce the incidence of deep I\u2010SSI.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>WP is a useful device for preventing superficial I\u2010SSI in open elective digestive surgery.<\/jats:p><\/jats:sec><jats:sec><jats:title>Trial registration number<\/jats:title><jats:p>UMIN000004723.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00268-017-4082-8","type":"journal-article","created":{"date-parts":[[2017,6,12]],"date-time":"2017-06-12T17:47:12Z","timestamp":1497289632000},"page":"2715-2722","update-policy":"http:\/\/dx.doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["The Benefits of a Wound Protector in Preventing Incisional Surgical Site Infection in Elective Open Digestive Surgery: A Large\u2010Scale Cohort 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