The effect of patient transfer type to the operating room on surgical site infection: Concerns versus evidence.

BACKGROUND: Concerns about surgical site infection (SSI) give rise to practices and procedures not evidence-based. OBJECTIVES: This study investigates whether the type of patient transfer to operating rooms plays a role in developing surgical site infection. METHODS: Three thousand four hundred and seventy-one patients were divided into two groups: transfer group with stretcher (ST) (n = 1699) and patient bed transfer group (PBT) (n = 1772). The data of the two groups and the SSI rates were comparatively analyzed. RESULTS: The SSI rate was 2.5% (n = 43) in the ST group and 2.8% (n = 49) in the PBT group, and there was no statistically significant difference. Both types of patient transfer had similar effects on the probability of SSI development. The odds ratio was 1.095 for stretcher transfer while 0.913 for patient bed transfer. CONCLUSION: Patients transfer to operating rooms on their beds are comfortable and safe. Furthermore, it has a similar effect to stretcher transfer on the probability of surgical site infection. Therefore, it is safer and cheaper to act based on evidence instead of trusting our concerns.

ANTECEDENTES: las preocupaciones sobre la infección del sitio quirúrgico (ISQ) dan lugar a prácticas y procedimientos que no se basan en pruebas. OBJETIVOS: Este estudio investiga si el tipo de traslado del paciente a los quirófanos influye en el desarrollo de la infección del sitio quirúrgico. MÉTODOS: Se dividieron 3471 pacientes en dos grupos: Grupo de transferencia con camilla (ST) (n = 1699) y Grupo de transferencia de cama de paciente (PBT) (n = 1772). Los datos de los dos grupos y las tasas de ISQ se analizaron comparativamente. RESULTADOS: La tasa de ISQ fue de 2.5% (n = 43) en el grupo ST y 2.8% (n = 49) en el grupo PBT, y no hubo diferencia estadísticamente significativa. Ambos tipos de transferencia de pacientes tuvieron efectos similares sobre la probabilidad de desarrollo de ISQ. La razón de posibilidades fue de 1.095 para el traslado en camilla y de 0,913 para el traslado de la cama del paciente. CONCLUSIÓN: El traslado de los pacientes a los quirófanos en sus camas es cómodo y seguro. Además, tiene un efecto similar al traslado en camilla sobre la probabilidad de infección del sitio quirúrgico. Por lo tanto, es más seguro y económico actuar en base a evidencias en lugar de confiar en nuestras preocupaciones.

Zig Maneuver in Total Extraperitoneal Inguinal Hernia Repair.

BACKGROUND: The difficulties in the hernia sac dissection in repairing large inguinal hernias with the endoscopic total extraperitoneal (TEP) technique prolong the operation and increase the risk of injury. This study investigates the effectiveness of the Zig maneuver (ligation of the hernia sac at the deep inguinal ring) in TEP in male patients with L3 inguinal hernia by European Hernia Society classification. MATERIALS AND METHODS: A total of 224 male patients with L3 inguinal hernia who underwent laparoscopic TEP surgery in 2018 and 2019 were retrospectively screened and included in the study. The patients were divided into 2 groups as Zig group (n=99) and the non-Zig group (n=125), depending on whether the Zig maneuver was performed during TEP application. RESULTS: The mean patient age was 45.49 for the non-Zig group and 47.12 for the Zig group. The median operative time was 50 minutes in the non-Zig group and 43 minutes in the Zig group (P<0.005). The median value of the postoperative first 24 hours pain score was 3 in the non-Zig group and 2 in the Zig group (P=0.033). Scrotal edema was 7.2% in the non-Zig group and 1% in the Zig group (P=0.023). According to logistic regression analysis, the Zig maneuver reduced the probability of scrotal edema by 87% in almost the entire population (odds ratio=0.130, 95% confidence interval: 0.016-1.047). There was no statistically significant difference between the groups in terms of early and late recurrence. CONCLUSIONS: Zig maneuver shortened the operative time and significantly reduced the feeling of pain in the first 24 hours postoperatively in male patients with indirect L3 hernia who underwent endoscopic TEP. It also significantly reduced the likelihood of scrotal edema in almost the entire population. As a result, the Zig maneuver is an effective method that could be applied during endoscopic TEP.