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The preventive effects of perioperative oral care on surgical site infections after pancreatic cancer surgery: a retrospective study

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Abstract

Purpose

Pancreatic ductal adenocarcinoma (PDAC) is the most malignant cancer of the gastrointestinal system, and is associated with high rates of postoperative complications, including surgical site infections (SSIs). Perioperative oral care is an effective measure for preventing postoperative pneumonia. However, the preventive effects of perioperative oral care on SSIs have not been reported. We investigated the preventive effects of perioperative oral care on SSIs after pancreatic cancer surgery.

Methods

A total of 103 patients with PDAC who underwent radical resection at Hiroshima Prefectural Hospital (2011–2018) were enrolled in this retrospective study. Of the 103 patients, 75 received perioperative oral care by dentists and dental hygienists (oral care group), whereas 28 did not (control group). Univariate and multivariate analyses with propensity score as a covariate were used to investigate the incidence and risk factors of SSIs in the oral care and control groups.

Results

The incidence of SSIs was significantly lower in the oral care group than in the control group (12.0% vs. 39.3%, P = 0.004). Logistic regression analysis revealed that a soft pancreas, the surgical procedure (pancreaticoduodenectomy), blood transfusion, diabetes mellitus, and the absence of oral care intervention were risk factors for SSIs. The odds ratio for the absence of oral care intervention was 6.090 (95% confidence interval: 1.750–21.200, P = 0.004).

Conclusion

Our results suggest that perioperative oral care may reduce the risk of developing SSIs after pancreatic cancer surgery. These findings need to be evaluated in future prospective studies.

Trial registration

UMIN registration number: UMIN000042082; October 15, 2020, retrospectively registered.

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Data availability

The data that support the findings of this study are available on request from the corresponding author. The data are not publicly available due to privacy or ethical restrictions.

Code availability

Not applicable.

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Acknowledgements

We would like to express our appreciation to the Departments of Gastroenterological, Breast and Transplant Surgery, Dentistry, and Clinical Nutrition, as well as the ward and operating room nurses and medical clerks at Hiroshima Prefectural Hospital. We would also like to thank Editage (www.editage.com) for their writing support.

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Authors and Affiliations

  1. Department of Dentistry, Hiroshima Prefectural Hospital, 1-5-54 Ujina-Kanda, Minami-ku, Hiroshima, 734-8530, Japan

    Hiroshi Nobuhara

  2. Department of Clinical Nutrition, Hiroshima Prefectural Hospital, 1-5-54 Ujina-Kanda, Minami-ku, Hiroshima, 734-8530, Japan

    Yasuhiro Matsugu & Keiko Ito

  3. Department of Gastroenterological, Breast and Transplant Surgery, Hiroshima Prefectural Hospital, 1-5-54 Ujina-Kanda, Minami-ku, Hiroshima, 734-8530, Japan

    Yasuhiro Matsugu

  4. Department of Epidemiology, Infectious Disease Control and Prevention, Graduate School of Biomedical & Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan

    Junko Tanaka & Tomoyuki Akita

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  1. Hiroshi Nobuhara
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Contributions

Conceptualization: Hiroshi Nobuhara and Yasuhiro Matsugu; data curation: Hiroshi Nobuhara, Yasuhiro Matsugu, and Keiko Ito; formal analysis: Junko Tanaka and Tomoyuki Akita; investigation: Hiroshi Nobuhara, Yasuhiro Matsugu Y, and Keiko Ito; writing — original draft preparation: Hiroshi Nobuhara; writing — review and editing: Hiroshi Nobuhara and Yasuhiro Matsugu. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Yasuhiro Matsugu.

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Ethics approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. The study was approved by the Institutional Review Board of Hiroshima Prefectural Hospital (Date April 22, 2019. No. 201712–13).

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The requirement for written informed consent was waived owing to the retrospective nature of the study.

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Not applicable.

Conflict of interest

The authors declare no competing interests.

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Nobuhara, H., Matsugu, Y., Tanaka, J. et al. The preventive effects of perioperative oral care on surgical site infections after pancreatic cancer surgery: a retrospective study. Support Care Cancer 30, 3337–3344 (2022). https://doi.org/10.1007/s00520-021-06791-9

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  • DOI: https://doi.org/10.1007/s00520-021-06791-9

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