Plastic iodophor drape during liver surgery operative use of the iodophor-impregnated adhesive drape to prevent wound infection during high risk surgery

Abstract

We retrospectively investigated factors associated with wound infection after liver resection for hepatocellular carcinoma (HCC), with special reference to use of a plastic adhesive drape impregnated with iodophor. The subjects were 296 patients undergoing liver resection for HCC. Wound infection was defined as purulent drainage from the superficial incision with or without laboratory confirmation. One or more of the following signs was required: pain or tenderness, localized swelling, or redness or heat. Wound infection developed in 25 patients. Regression analysis indicated that low body mass index (BMI), smoking, long preoperative hospital stay, and nonuse of iodophor drapes were risk factors for wound infection. Wound infection was significantly less likely with the use of iodophor drapes (3.1%) than for surgery without iodophor drapes (12.1%). By multivariate regression analysis, BMI, smoking, and lack of drape use were independent risk factors. Most of the bacteria isolated were skin bacteria, including Staphylococcus aureus and Staphylococcus epidermidis. In conclusion, low BMI, smoking, a long preoperative hospital stay, and the lack of iodophor drape use were risk factors for wound infection after liver resection for HCC. The drapes presumably prevented contamination from the skin during the operation.