{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T11:36:22Z","timestamp":1792150582484,"version":"4.4.0"},"reference-count":49,"publisher":"SAGE Publications","issue":"6","license":[{"start":{"date-parts":[[2026,2,1]],"date-time":"2026-02-01T00:00:00Z","timestamp":1769904000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"name":"Clinical Center","award":["T32GM008792"],"award-info":[{"award-number":["T32GM008792"]}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Surgical Infections"],"published-print":{"date-parts":[[2026,8,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Damage control laparotomy (DCL) rates have declined and remained low. Given DCL\u2019s association with surgical site infections (SSIs), we hypothesize that SSI rates and severity, as per Clavien\u2013Dindo (CD) classification, have decreased concurrently.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patients and Methods:<\/jats:title>\n                    <jats:p>A retrospective study was performed on patients (\u226516 y) who underwent trauma laparotomy from January 2011 to December 2020. Patients who survived \u226448 hours were excluded. Data were divided into period 1 (January 2011\u2013December 2015, DCL rates declined) and period 2 (January 2016\u2013December 2020, low DCL rates were sustained). SSIs were defined as per the Centers for Disease Control and Prevention, and severity was graded by the CD scale (I\u2013V). SSIs were classified as minor (CD grade I\u2013II) and major (CD grade III\u2013V). Uni-variable and multi-variable analyses were performed (p &lt; 0.05).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      In total 1,975 patients met the inclusion criteria. Between periods 1 and 2, there was an increase in injury severity score (ISS); (19 [IQR: 10, 29] vs. 21 [IQR: 12, 34],\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2264 0.001) and penetrating injuries (426 [44%] vs. 513 [51%],\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      = 0.002), with a decrease in DCL (283 [29%] vs. 153 [15%],\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2264 0.001). A total of 355 (18%) patients developed an SSI, 18.5% (179) in period 1 and 17.5% (176) in period 2 (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      = 0.5). On multi-variable analysis, after controlling for mechanism of injury, emergency room systolic blood pressure, wound classification, large bowel resection, ISS, splenectomy, and operating-room time at index laparotomy, DCL was associated with major SSIs.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Despite decreases in DCL, SSI rates and severity after trauma laparotomy remain stable, potentially because of increased injury severity and penetrating trauma. Identification of other potential modifiable risk factors is needed to decrease SSI incidence and severity.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/10962964261419732","type":"journal-article","created":{"date-parts":[[2026,2,2]],"date-time":"2026-02-02T06:22:47Z","timestamp":1770013367000},"page":"430-438","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Are Fewer Damage Control Laparotomies Associated with a Decrease in the Rate and Severity of Surgical Site Infections?"],"prefix":"10.1177","volume":"27","author":[{"given":"Stephanie","family":"Martinez Ugarte","sequence":"first","affiliation":[{"name":"Center for Translational Injury Research, Department of Surgery, McGovern Medical School at The University of Texas Health Science Center at Houston, Houston, Texas, USA."},{"name":"Department of Surgery, Division of Acute Care Surgery, McGovern Medical School at The University of Texas Health Science Center at Houston, Houston, Texas, USA."},{"name":"Center for Surgical Trials and Evidence-based Practice (C-STEP), McGovern Medical School at The University of Texas Health Science Center at Houston, Houston, Texas, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mokunfayo O.","family":"Fajemisin","sequence":"additional","affiliation":[{"name":"Center for Translational Injury Research, Department of Surgery, McGovern Medical School at The University of Texas Health Science Center at Houston, Houston, Texas, USA."},{"name":"Department of Surgery, Division of Acute Care Surgery, McGovern Medical School at The University of Texas Health Science Center at Houston, Houston, Texas, USA."},{"name":"Center for Surgical Trials and Evidence-based Practice (C-STEP), McGovern Medical School at The University of Texas Health Science Center at Houston, Houston, Texas, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chelsea J.","family":"Guy-Frank","sequence":"additional","affiliation":[{"name":"Department of Surgery, Division of Acute Care Surgery, McGovern Medical School at The University of Texas Health Science Center at Houston, Houston, Texas, USA."},{"name":"Center for Surgical Trials and Evidence-based Practice (C-STEP), McGovern Medical School at The University of Texas Health Science Center at Houston, Houston, Texas, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William D.","family":"Rieger","sequence":"additional","affiliation":[{"name":"Center for Translational Injury Research, Department of Surgery, McGovern Medical School at The University of Texas Health Science Center at Houston, Houston, Texas, USA."},{"name":"Department of Surgery, Division of Acute Care Surgery, McGovern Medical School at The University of Texas Health Science Center at Houston, Houston, Texas, USA."},{"name":"Center for Surgical Trials and Evidence-based Practice (C-STEP), McGovern Medical School at The University of Texas Health Science Center at Houston, Houston, Texas, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Renee W.","family":"Green","sequence":"additional","affiliation":[{"name":"Center for Translational Injury Research, Department of Surgery, McGovern Medical School at The University of Texas Health Science Center at Houston, Houston, Texas, USA."},{"name":"Department of Surgery, Division of Acute Care Surgery, McGovern Medical School at The University of Texas Health Science Center at Houston, Houston, Texas, USA."},{"name":"Center for Surgical Trials and Evidence-based Practice (C-STEP), McGovern Medical School at The University of Texas Health Science Center at Houston, Houston, Texas, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John A.","family":"Harvin","sequence":"additional","affiliation":[{"name":"Center for Translational Injury Research, Department of Surgery, McGovern Medical School at The University of Texas Health Science Center at Houston, Houston, Texas, USA."},{"name":"Department of Surgery, Division of Acute Care Surgery, McGovern Medical School at The University of Texas Health Science Center at Houston, Houston, Texas, USA."},{"name":"Center for Surgical Trials and Evidence-based Practice (C-STEP), McGovern Medical School at The University of Texas Health Science Center at Houston, Houston, Texas, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lillian S.","family":"Kao","sequence":"additional","affiliation":[{"name":"Center for Translational Injury Research, Department of Surgery, McGovern Medical School at The University of Texas Health Science Center at Houston, Houston, Texas, USA."},{"name":"Department of Surgery, Division of Acute Care Surgery, McGovern Medical School at The University of Texas Health Science Center at Houston, Houston, Texas, USA."},{"name":"Center for Surgical Trials and Evidence-based Practice (C-STEP), McGovern Medical School at The University of Texas Health Science Center at Houston, Houston, Texas, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,2,1]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0000000000001803"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1080\/00015458.2002.11679322"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jamcollsurg.2016.06.002"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1097\/TA.0b013e31823cd78d"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjsurg.2015.10.014"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1136\/tsaco-2021-000706"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jamcollsurg.2016.10.029"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1089\/sur.2012.131"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamainternmed.2013.9763"},{"key":"e_1_3_3_11_2","unstructured":"National Healthcare Safety Network Centers for Disease Control and Prevention. Surgical site infection (SSI) event. National Healthcare Safety Network Centers for Disease Control and Prevention. 2025. Available from: www.cdc.gov\/nhsn\/pdfs\/pscmanual\/9pscssicurrent.pdf"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.sla.0000133083.54934.ae"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0b013e3181b13ca2"},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.1089\/sur.2024.137"},{"key":"e_1_3_3_15_2","unstructured":"Risk factors for impaired wound healing and wound complications - UpToDate. n.d. Available from: https:\/\/www.uptodate.com\/contents\/risk-factors-for-impaired-wound-healing-and-wound-complications?sectionName=SMOKING%20AND%20NICOTINE%20REPLACEMENT%20THERAPY&topicRef=4044&anchor=H179550987&source=see_link#H179550987 [Last accessed: May5 2025]."},{"key":"e_1_3_3_16_2","doi-asserted-by":"publisher","DOI":"10.1177\/000313480507100309"},{"key":"e_1_3_3_17_2","doi-asserted-by":"publisher","DOI":"10.1089\/sur.2020.242"},{"key":"e_1_3_3_18_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jamcollsurg.2017.04.010"},{"key":"e_1_3_3_19_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2007.11.008"},{"key":"e_1_3_3_20_2","doi-asserted-by":"publisher","DOI":"10.1186\/1754-9493-8-31"},{"key":"e_1_3_3_21_2","doi-asserted-by":"publisher","DOI":"10.1097\/TA.0000000000002486"},{"key":"e_1_3_3_22_2","doi-asserted-by":"publisher","DOI":"10.1097\/TA.0000000000003109"},{"key":"e_1_3_3_23_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.surg.2016.05.044"},{"key":"e_1_3_3_24_2","doi-asserted-by":"publisher","DOI":"10.1136\/tsaco-2021-000777"},{"key":"e_1_3_3_25_2","doi-asserted-by":"publisher","DOI":"10.1097\/TA.0000000000002143"},{"key":"e_1_3_3_26_2","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.9685"},{"key":"e_1_3_3_27_2","doi-asserted-by":"publisher","DOI":"10.1097\/TA.0b013e31827e2589"},{"key":"e_1_3_3_28_2","doi-asserted-by":"publisher","DOI":"10.1089\/sur.2017.018"},{"key":"e_1_3_3_29_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamasurg.2018.3467"},{"key":"e_1_3_3_30_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00268-023-06908-7"},{"key":"e_1_3_3_31_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.surg.2022.05.020"},{"key":"e_1_3_3_32_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.injury.2024.111906"},{"key":"e_1_3_3_33_2","doi-asserted-by":"publisher","DOI":"10.1097\/TA.0000000000000132"},{"key":"e_1_3_3_34_2","doi-asserted-by":"publisher","DOI":"10.1177\/000313480707300613"},{"key":"e_1_3_3_35_2","doi-asserted-by":"publisher","DOI":"10.1097\/TA.0000000000001349"},{"key":"e_1_3_3_36_2","doi-asserted-by":"publisher","DOI":"10.1097\/TA.0b013e31823d0691"},{"key":"e_1_3_3_37_2","doi-asserted-by":"publisher","DOI":"10.1111\/ans.16939"},{"key":"e_1_3_3_38_2","doi-asserted-by":"publisher","DOI":"10.1097\/TA.0000000000000393"},{"key":"e_1_3_3_39_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.injury.2024.111361"},{"key":"e_1_3_3_40_2","doi-asserted-by":"publisher","DOI":"10.1089\/sur.2024.128"},{"key":"e_1_3_3_41_2","doi-asserted-by":"publisher","DOI":"10.1089\/sur.2022.393"},{"key":"e_1_3_3_42_2","doi-asserted-by":"publisher","DOI":"10.1089\/sur.2017.089"},{"key":"e_1_3_3_43_2","doi-asserted-by":"publisher","DOI":"10.1097\/TA.0b013e31827e2a96"},{"key":"e_1_3_3_44_2","doi-asserted-by":"publisher","DOI":"10.7759\/cureus.70583"},{"key":"e_1_3_3_45_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13017-023-00475-x"},{"key":"e_1_3_3_46_2","doi-asserted-by":"publisher","DOI":"10.1097\/TA.0000000000002170"},{"key":"e_1_3_3_47_2","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.9360"},{"key":"e_1_3_3_48_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00268-018-04899-4"},{"key":"e_1_3_3_49_2","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/aeu233"},{"key":"e_1_3_3_50_2","doi-asserted-by":"publisher","DOI":"10.1097\/TA.0000000000004436"}],"container-title":["Surgical Infections"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/10962964261419732","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/10962964261419732","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/10962964261419732","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,18]],"date-time":"2026-07-18T04:39:15Z","timestamp":1784349555000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/10962964261419732"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2,1]]},"references-count":49,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2026,8,1]]}},"alternative-id":["10.1177\/10962964261419732"],"URL":"https:\/\/doi.org\/10.1177\/10962964261419732","relation":{},"ISSN":["1096-2964","1557-8674"],"issn-type":[{"value":"1096-2964","type":"print"},{"value":"1557-8674","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,2,1]]}}}