Background: Sarcopenia is a syndrome that can have negative consequences after gastric cancer (GC) surgery. This study aims to determine the effect of sarcopenia on surgical site infection (SSI) that develops after open GC surgery. Patients and Methods: In this retrospective design study, data were collected for patients who underwent GC surgery between January 2013 and August 2019. The diagnosis of sarcopenia was made according to the skeletal muscle index (SMI) calculated from pre-operative computed tomography images. Patients with sarcopenia and those without sarcopenia were compared in terms of SSIs; the risk factors for SSI were also analyzed. Results: One hundred forty-nine patients were included in the study and had a mean age of 59.3 years. Post-operative complications developed in 59 patients (39.6%) and SSIs in 28 patients (18.7%). Sarcopenia was detected in 57 (38.3%) patients; the mean age was 59.9 years in the sarcopenic group (SG) and 58.9 years in the non-sarcopenic group (NSG; p = 0.55). The mean SMI was 382.5 mm²/m² and 646.2 mm²/m² in the SG and NSG, respectively (p < 0.001). A relation between SSIs and sarcopenia was detected; 17 patients in the SG (29.8%) versus 11 patients in the NSG (11.9%; p = 0.007). Surgical site infection was not found to be statistically significantly related to obesity, hypoalbuminemia, intra-operative blood loss, or duration of operation, although the sarcopenic obesity patients were found to have the highest SSI rate (40%). Conclusion: The present study identified a relation between sarcopenia and SSIs occurring after GC surgery. The authors believe that studies seeking to reduce the incidence of SSIs, which are a leading cause of morbidity after GC surgery, should be supported.

Background: Surgical site infections (SSIs) are a serious problem after abdominal surgery. This study aimed to compare closure of fascia with triclosan-coated monofilament polydioxanone (PDS) or standard PDS in decreasing the incidence of SSIs in patients who underwent abdominal surgery. Methods: In this randomized study, a total of 890 consecutive patients undergoing laparotomy for any gastrointestinal pathology were allocated to closure of the fascia with triclosan-coated PDS (treatment group; TG) or standard PDS (control group; CG). Patients were assessed every day during the hospital stay for SSIs and at the first, second, and fourth week after discharge. The surgical site was assessed in terms of superficial, deep incisional, or organ/site SSI. Results: The main important finding was that SSIs were reduced as much as 24% by using triclosan-coated PDS. Surgical site infections occurred in 200 patients (22.4%), with 105 being early (in the first week) and 95 occurring late. Eighty five of the SSIs (19.1%) were noted in patients in the TG, whereas 115 of them (25.8%) were in the CG (p = 0.016). The infections were superficial in 126 patients, deep incisional in 48 patients, and organ/site in 26 patients. Most of patients (n = 651) had clean-contaminated sites. In subgroup analysis, SSI rates with triclosan-coated PDS were lower in clean, clean-contaminated, and contaminated incisions (0 in the TG versus 24.2% in the CG; p = 0.009; 13.6% in the TG versus 24.3% in the CG, p = 0.001; and 16.6% in the TG versus 27.8% in the CG; p < 0.0001, respectively). Conclusions: Closure of the fascia with triclosan-coated PDS decreased SSI rates as much as 24%. Also, SSIs were decreased significantly at clean, clean-contaminated, and contaminated sites. Therefore, triclosan-coated PDS might be recommended for fascial closure as a means of decreasing SSIs.

Introduction: Studies have shown that sarcopenia is associated with poor outcomes in patients with gastrointestinal cancer undergoing surgery. We aimed to investigate the relationship between postoperative complications of sarcopenic patients who had been operated on for colon cancer and the effects on short-term mortality.Material and methods: In this study, patients who had undergone colon cancer surgery between January 2013 and December 2018 were collected retrospectively. Sarcopenia was diagnosed by the skeletal muscle index (SMI) derived from a preoperative computed tomography scan. Multiple logistic regression analysis was performed to determine whether sarcopenia is associated with postoperative major complications (POMC).Results: The study included 160 patients with a mean age of 62.4 ±12.6 years. Clavien-Dindo grade 1–2 (minor) complications were not significantly different between the groups (p = 0.896). However, grade ≥ 3 (major) complications were detected in 13 (17.8%) patients in the sarcopenic group (SG) and in 5 patients in the non-sarcopenic group (NSG) (5.7%) (p = 0.016). Length of intensive care unit (ICU) stay was longer in SG (p = 0.002) and there was no difference between 1-month and 6-month mortality rates (p = 0.273 and p = 0.402, respectively). According to univariate analyses, sarcopenia and age over 65 years were related to POMC. In multivariate analyses, sarcopenia (odds ratio = 3.039; 95% confidence interval 1.008–9.174; p = 0.048) and advanced age (odds ratio = 3.246; 95% confidence interval 1.078–9.803; p = 0.036) were found to be independent risk factors for POMC.Conclusions: This study showed that while sarcopenia is a risk factor for POMC, sarcopenia also prolongs the duration of ICU stay. Also sarcopenia has no effect on short-term mortality.

Background: Sarcopenia is a syndrome that can be associated with unfavorable outcomes after colorectal cancer surgical procedures. The present study evaluates the relationship between sarcopenia and surgical site infections (SSIs) that can occur after colorectal cancer operations and that are a significant cause of morbidity. Methods: The research was designed as a retrospective study in which data were collected on patients who underwent colorectal cancer surgical procedures between January 2013 and July 2019. A diagnosis of sarcopenia was established based on the skeletal muscle index (SMI), calculated from pre-operative computed tomography scans. The SSI scores of patients with sarcopenia (sarcopenic group, SG) and those without sarcopenia (non-sarcopenic group, NSG) were compared, and a logistic regression analysis was performed to determine the risk factors for SSI. Results: A total of 209 patients with a mean age of 61.2 years were included in the study. Post-operative complications (Clavien-Dindo ≥1) developed in 97 (46.4%) patients, SSIs developed in 46 (22%) patients, and sarcopenia developed in 97 (46.4%) patients. The mean age was 64.8 years in the SG group and 58.1 years in the NSG group (p = 0.016). No significant relationship was found between the development of SSI and sarcopenia (20 (20.6%) patients in the SG vs. 26 (23.2%) patients in the NSG, p = 0.65). Those in whom superficial SSIs developed in the early period formed the largest group (20 patients). The most commonly detected micro-organism was Escherichia coli with a rate of 55%. In a multi-variable logistic regression analysis, only the non-laparoscopic approach was identified as a risk factor (odds ratio 3.83; 95% confidence interval 1.26–11.58; p = 0.017). Conclusions: The present study reports no relationship between sarcopenia and SSI after colorectal cancer operations. The authors consider that studies that endeavor to reduce the incidence of SSI, as a significant cause of morbidity after colorectal surgical procedures, should be supported.

Gossypiboma, an infrequent surgical complication, is a mass lesion due to a retained surgical sponge surrounded by foreign body reaction. In this case report, we describe gossypiboma in the abdominal cavity which was detected 14 months after the hysterectomy due to acute abdominal pain. Gossypiboma was diagnosed by computed tomography (CT). The CT findings were a rounded mass with a dense central part and an enhancing wall. In explorative laparotomy, small bowel loops were seen to be perforated due to inflammation of long standing gossypiboma. Jejunal resection with end-to-end anastomosis was performed. The patient was discharged whithout complication. This case was presented to point to retained foreign body (RFB) complications and we believed that the possibility of a retained foreign body should be considered in the differential diagnosis of who had previous surgery and complained of pain, infection, or palpable mass.