Journal List > Korean J Urogenit Tract Infect Inflamm > v.10(1) > 1059908

Yoo, Seo, Lee, and Kim: Efficacy of Collatamp on Pediatric Urologic Surgery

Abstract

Purpose

The purpose of this study is to evaluate efficacy of Collatamp (EUSA Pharma [Europe]; a gentamicin-containing collagen implant, GCCI) in pediatric urologic surgery.

Materials and Methods

The study comprised a retrospective analysis of 35 consecutive children who underwent pediatric urologic surgery for treatment of hydrocele, undescended testis and varicocele between March 2013 and March 2015. Collatamp containing 130 mg gentamicin and 280 mg collagen were immersed in 300 ml normal saline for up to 6 hours. At set times after immersion the GCCI were removed, the saline diluted in normal human serum and the gentamicin content assayed by a validated immunoassay (Cedia, Microgenics Ltd., UK) to provide an estimate of the loss from each implant. Patients were classified according to two groups: patients with Collatamp (group A) and those without Collatamp (group B). Postoperative complication, operative time and age, etc. were assessed at postoperative 7 days.

Results

Sixteen hydrocele, 16 undescended testis, and 3 varicocele patients were identified, with a median age of 87.43±54.10 months, operation time of 103.60±29.41 minutes, and hospitalization period of 3.20±0.68 days. Mean age, operation time, and hospitalization period in group A, B was 64.81±60.32 months, 100.80±46.80 months (p=0.02), 122.30±40.70 minutes, 103.61±29.39 minutes (p=0.17), and 3.20±0.40 days, 3.20±0.80 days (p=0.67), respectively. No statistically significant differences in postoperative complication were observed between the two groups. However, cost was higher in group A than in group B (300,000 won vs, 15,900.82±3,905.72 won).

Conclusions

Collatamp may be useful and effective in preventing wound infection in pediatric urologic surgery, although Collatamp is more expensive.

REFERENCES

1. Kanamaru S, Terai A, Ishitoya S, Kunishima Y, Nishiyama H, Segawa T, et al. Assessment of a protocol for prophylactic antibiotics to prevent perioperative infection in urological surgery: a preliminary study. Int J Urol. 2004; 11:355–63.
crossref
2. Chang WK, Srinivasa S, MacCormick AD, Hill AG. Gentamicin-collagen implants to reduce surgical site infection: systematic review and metaanalysis of randomized trials. Ann Surg. 2013; 258:59–65.
3. Picó RB, Jiménez LA, Sánchez MC, Castelló CH, Bilbao AM, Arias MP, et al. Prospective study comparing the incidence of wound infection following appendectomy for acute appendicitis in children: conventional treatment versus using reabsorbable antibacterial suture or gentamicin-impregnated collagen fleeces. Cir Pediatr. 2008; 21:199–202.
4. Mangram AJ, Horan TC, Pearson ML, Silver LC, Jarvis WR. Guideline for prevention of surgical site infection, 1999. Centers for Disease Control and Prevention (CDC) Hospital Infection Control Practices Advisory Committee. Am J Infect Control. 1999; 27:97–132. quiz 133-4; discussion 96.
5. Laxenaire MC. Epidemiology of anesthetic anaphylactoid reactions. Fourth multicenter survey (July 1994-December 1996). Ann Fr Anesth Reanim. 1999; 18:796–809.
6. Lee CW, Castells MC. Perioperative anaphylaxis to cefazolin. Allergy Asthma Proc. 2004; 25:23–6.
7. Espin-Basany E, Sanchez-Garcia JL, Lopez-Cano M, Lozoya-Trujillo R, Medarde-Ferrer M, Armadans-Gil L, et al. Prospective, randomised study on antibiotic prophylaxis in colorectal surgery. Is it really necessary to use oral antibiotics? Int J Colorectal Dis. 2005; 20:542–6.
8. Rangel SJ, Fung M, Graham DA, Ma L, Nelson CP, Sandora TJ. Recent trends in the use of antibiotic prophylaxis in pediatric surgery. J Pediatr Surg. 2011; 46:366–71.
crossref
9. Bratzler DW, Houck PM. Surgical Infection Prevention Guideline Writers Workgroup. Antimicrobial prophylaxis for surgery: an advisory statement from the National Surgical Infection Prevention Project. Am J Surg. 2005; 189:395–404.
crossref
10. Haas H, Schneider G, Moulin F. Antibiotic prophylaxis in visceral and urologic pædiatric surgery. Arch Pediatr. 2013; 20(Suppl 3):S67–73.
11. Meijer WS, Schmitz PI, Jeekel J. Metaanalysis of randomized, controlled clinical trials of antibiotic prophylaxis in biliary tract surgery. Br J Surg. 1990; 77:283–90.
crossref
12. Page CP, Bohnen JM, Fletcher JR, McManus AT, Solomkin JS, Wittmann DH. Antimicrobial prophylaxis for surgical wounds. Guidelines for clinical care. Arch Surg. 1993; 128:79–88.
13. Vuorisalo S, Pokela R, Syrjälä H. Is single-dose antibiotic prophylaxis sufficient for coronary artery bypass surgery? An analysis of peri- and postoperative serum cefuroxime and vancomycin levels. J Hosp Infect. 1997; 37:237–47.
crossref
14. Hsieh MH, Wildenfels P, Gonzales ET Jr. Surgical antibiotic practices among pediatric urologists in the United States. J Pediatr Urol. 2011; 7:192–7.
crossref
15. Chung JM, Lee SD. Korean Society of Pediatric Urology. The use of prophylactic antibiotics in pediatric urologic surgery: a questionnaire survey of pediatric urologist in Korea. J Korean Pediatr Urol. 2010; 2:29–37.
16. Bennett-Guerrero E, Pappas TN, Koltun WA, Fleshman JW, Lin M, Garg J, et al. SWIPE 2 Trial Group. Gentamicin-collagen sponge for infection prophylaxis in colorectal surgery. N Engl J Med. 2010; 363:1038–49.
crossref
17. Nam HJ, Jeong SC, Kong MY, Lee KS, Lee SD. Trial for clinical guideline of the use of prophylactic antibiotics in pediatric urologic outpatient surgery. Korean J Urogenit Tract Infect Inflamm. 2012; 7:50–5.

Table 1.
Patient characterisitics
Variable Value
Age (mo) 87.43±54.10
Operation name  
 Hydrocelectomy 16
 Orchiopexy 16
 Varicocelectomy 3
Operation time (min) 103.60±29.41
Length of stay (d) 3.20±0.68

Values are presented as mean±standard deviation or number only.

Table 2.
Comparison of outcomes of treatment with (group A) and without Collatamp (group B)
Variable Group A (n=13) Group B (n=22) p-value
Age (mo) 64.81±60.32 100.80±46.80 0.02
Operation time (min) 122.30±40.70 103.61±29.39 0.17
Length of stay (d) 3.20±0.40 3.20±0.80 0.67
Operation     0.24
 Varicocelectomy 1 (7.69) 2 (9.10)  
 Hydrocelectomy 4 (30.77) 12 (54.55)  
 Orchiopexy 8 (61.54) 8 (36.36)  
Complication 0 0  

Values are presented as mean±standard deviation, number (%), or number only.

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