Effect of local gentamicin–collagen on perineal wound complications and cancer recurrence after abdominoperineal resection: a multicentre randomized controlled trial

Collin, Åsa; Gustafsson, Ulla-Maria; Smedh, K.; Påhlman, Lars; Graf, Wilhelm; Folkesson, Joakim

doi:10.1111/j.1463-1318.2012.03196.x

Cited by 20 publications

(28 citation statements)

References 19 publications

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“…I would like to commend Collin and colleagues for their paper addressing whether locally administered gentamicin reduces cancer recurrence . This paper followed a surprising finding by Nowacki and colleagues that locally administered gentamicin reduced distant metastasis and significantly improved overall survival .…”

Section: The Effect Of Gentamicin On Survivalmentioning

confidence: 97%

Gentamicin, a read‐through agent for the treatment of rectal cancer

Frumkin¹

2017

Colorectal Disease

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Section: The Effect Of Gentamicin On Survivalmentioning

confidence: 97%

Gentamicin, a read‐through agent for the treatment of rectal cancer

Frumkin¹

2017

Colorectal Disease

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“…Similarly, the use of biological mesh is controversial . Other attempts to reduce infectious complications have included local gentamicin application, which appears to be ineffective, and omentoplasty, which was shown to result in faster wound healing and decreased wound infection rates …”

Section: Introductionmentioning

confidence: 99%

The application of incisional negative pressure wound therapy for perineal wounds: A systematic review

Cahill

Fowler

Williams

2018

International Wound Journal

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Impaired perineal wound healing is a major source of morbidity after abdominoperineal resection. Incisional negative pressure wound therapy can improve healing, prevent infections, and decrease the frequency of dehiscence. Our objective was to summarise existing evidence on the use of incisional negative pressure wound therapy on perineal wounds after abdominoperineal resection and to determine the effect on perineal wound complications. Electronic databases were searched in January 2017. Studies describing the use of incisional negative pressure wound therapy on primarily closed perineal wounds after abdominoperineal resection were included. Of the 278 identified articles, 5 were retrieved for inclusion in the systematic review (n = 169 patients). A significant decrease in perineal wound complications when using incisional negative pressure wound therapy was demonstrated, with surgical site infection rates as low as 9% (vs 41% in control groups). The major limitation of this systematic review was a small number of retrieved studies with small patient populations, high heterogeneity, and methodological issues. This review suggests that incisional negative pressure wound therapy decreases perineal wound complications after abdominoperineal resection. Further prospective trials with larger patient populations would be needed to confirm this association and delineate which patients might benefit most from the intervention.

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“…Experience from several randomized studies has suggested that local application of gentamicin collagen implant (GCI) may reduce the rate of surgical site infection (SSI) [ 1 – 5 ], whereas other multicenter, randomized studies have shown GCI had no effect [ 6 , 7 ]. Only four studies focused on patients with rectal cancer [ 2 – 4 , 6 ] and only in one did all patients receive preoperative short-term radiotherapy [ 4 ]. In most of these studies, the GCI was inserted into the wound above the abdominal fascia or into the sacral wound after abdominoperineal resection (APR) and complete closure of the pelvic peritoneal floor at the level with the remnants of the levators.…”

Section: Introductionmentioning

confidence: 99%

Surgical site infections following short-term radiotherapy and total mesorectal excision: results of a randomized study examining the role of gentamicin collagen implant in rectal cancer surgery

et al. 2014

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BackgroundDespite the findings of several randomized clinical studies, the role of gentamicin collagen implant (GCI) in rectal cancer surgery is unclear. Local pelvic application of GCI following preoperative radiotherapy and total mesorectal excision (TME) was evaluated to determine the risk of surgical site infections (SSI).MethodsIn this single-center trial, 176 patients with rectal cancer after preoperative, short-term radiotherapy (5 × 5 Gy) were randomized either to the study group in which GCI was used or in the control group without GCI. Prior to surgery and intraoperatively five patients were excluded from the study. The remaining 171 patients were analyzed; 86 were in the study group and 85 in the control group.ResultsThere were no statistically significant differences in the overall rate of early postoperative complications between the study and control group: 25.6 and 34.1 % respectively; p = 0.245, relative risk (RR) 0.750 [95 % confidence interval (CI) 0.471–1.195]. The reoperation rate was similar in both groups: 12.8 versus 9.4 %; p = 0.628; RR 1.359; (95 % CI 0.575–3.212). The total rate of SSI and organ space SSI were 22.2 and 15.8 % without differences between the study and control group. In patients without anastomotic leakage, the risk of organ space SSI was significantly reduced in patients who received GCI: 2.6 versus 13.0 %; p = 0.018.ConclusionsApplication of GCI in the pelvic cavity after short-term preoperative radiotherapy and TME may reduce the risk of organ space SSI but only in the absence of anastomotic leakage.

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Effect of local gentamicin–collagen on perineal wound complications and cancer recurrence after abdominoperineal resection: a multicentre randomized controlled trial

Abstract: There was no statistically significant effect on perineal wound complications or cancer recurrence following the local administration of gentamicin-collagen during APR.

Cited by 20 publications

References 19 publications

Gentamicin, a read‐through agent for the treatment of rectal cancer

Gentamicin, a read‐through agent for the treatment of rectal cancer

The application of incisional negative pressure wound therapy for perineal wounds: A systematic review

Surgical site infections following short-term radiotherapy and total mesorectal excision: results of a randomized study examining the role of gentamicin collagen implant in rectal cancer surgery

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