Randomized, Controlled Investigation of the Anti-Infective Properties of the Alexis Retractor/Protector of Incision Sites

Abstract

It was suggested that the use of the Alexis wound retractor would protect surgical wounds from contamination by bacteria and thus prevent infection.

Use of an upper midline incision for living donor partial hepatectomy: A series of 143 consecutive cases

“…The use of the Alexis wound protector has been reported to protect surgical wounds from contamination by bacteria and, consequently, to prevent infection during gastrointestinal surgery. 9 Horiuchi et al 10 reported that the use of the Alexis retractor at incision sites during gastric and colorectal surgery significantly reduced the incidence of wound infections (superficial infections at the sites of surgical incisions) in a randomized controlled study. The same wound protector also significantly reduced the risk of wound complications in this study.…”

Totally laparoscopic sigmoid colectomy with transanal specimen extraction

“…The Alexis, a polyurethane wound retractor manufactured by Applied Medical, was initially developed to protect against abdominal wounds [10]. It has a flexible cylindrical membrane attached to two semirigid rings on each end.…”

Laparoscopic one-stage resection of right and left colon complicated diverticulitis equivalent to hinchey stage I–II

“…We think that wound infection refl ects the still active infl ammatory process in complicated diverticulitis and possibly the persistence of bacteria in the pericolic fatty tissue. According to Horiuchi et al,48 the use of a wound retractor can protect surgical wounds from contamination by bacteria and thus prevent infection. Our low rate of wound infection may be attributed to the fact that we always used a wound protector intraoperatively to remove the specimen and perform anastomosis without direct contact with the trocar wounds.…”

“…Our low rate of wound infection may be attributed to the fact that we always used a wound protector intraoperatively to remove the specimen and perform anastomosis without direct contact with the trocar wounds. 44,48 Various surgical interventions for complicated diverticulitis include three-stage colostomy, resection, and anastomosis; two-stage Hartmann's procedure; and onestage resection and primary anastomosis. Some trials have demonstrated that complications were more closely associated with the three-stage procedure than with Hartmann's procedure.…”

“…19,39,[41][42][43] The overall conversion rate in our study was 2.8% (1/36), which was lower than that for complicated diverticulitis as reported in other studies. 40,[42][43][44][45][46][47][48] This was probably because surgery was carried out by four experienced laparoscopic surgeons beyond the learning curve. Only one patient required conversion to an open procedure after laparoscopy.…”