Purpose: This study was aimed to evaluate the efficacy of preoperative skin cleansing with Olanexidine Gluconate (OLG) compared to Povidone-iodine（PVI）in preventing superficial incisional surgical site infection (S-SSI) in hepato-biliary-pancreatic open surgery. Methods: We investigated patients who underwent open hepatectomy or pancreatectomy from October 2018 to March 2023 at the Department of Hepato-Biliary-Pancreatic Surgery, Ehime University. PVI was used in all cases until December 2020 (PVI-group), while OLG was used in all cases from January 2021．We surveyed the presence of S-SSI based on CDC guidelines. We also evaluated patient demographic data, anthropometric parameters, and perioperative data. Result: The PVI and OLG groups included 166 and 133 patients, respectively. The incidence of S-SSI was 3.0% (5 patients) in the PVI group and 2.3% (3 patients) in the OLG group, indicating no statistically significant difference. Conclusion：OLG did not show a significant reduction of S-SSIs. Therefore, depending on the cost and convenience, we can use both antisepses properly.

Background: The incidence of surgical site infection (SSI) in the field of gastrointestinal surgery is high, but there is a lack of evidence regarding the economic impact of SSI. This study examined the impact of SSIs on total healthcare costs using an online patient information rating system (electronic Patient Reported Outcome: ePRO). Methods: The total healthcare costs of 19 patients of hepatectomy and 18 patients of pancreatectomy were compared between October 2020 and August 2022, using ePRO. Results: The incidence of SSI was 16% for hepatectomy and 28% for pancreatectomy. The total healthcare costs for the SSI-non-incident group were 436 ± 128 thousand yen and SSI-incident group were 1,208 ± 686 thousand yen (P ＜ 0.01). The total healthcare costs for the SSI-incident group were significantly higher than that for the SSI-non-incident group. Conclusion：Using ePRO, it was possible to verify that the development of SSI significantly increased the total healthcare cost in patients who underwent hepatectomy or pancreatectomy.

We investigated the impact of postoperative infectious complications on the prognosis of elderly patients aged 80 and older. The study included 120 cases of elective gastrointestinal cancer surgery (colorectal and gastric cancer) performed between 2013 and 2019. The postoperative infectious complication group (n=24, PI group) and the control group (n=96, non-PI group) were divided, and the oncological prognosis was analyzed. The postoperative 5-year overall survival (OS) rates were 63% in the PI group and 69％ in the non-PI group (P=0.64). The postoperative 5-year cancer-specific survival (CSS) rates were 88％ in the PI group and 81% in the non-PI group (P=0.53). There was no significant difference in OS and CSS between the two groups. In the multivariate analysis of Cox regression analysis regarding OS, gender (male), gastric cancer, and stage were selected as significant factors. In the elderly population, it was suggested that infectious complications do not impact the oncological prognosis.

Perioperative pharmacotherapy in the surgical setting is becoming increasingly diverse and requires the active involvement of pharmacists. This study assessed the impact of information provided by unit pharmacists on perioperative infection control in a gastroenterology surgical unit by analyzing the content and acceptability of information to surgeons and nurses from July 2015 to June 2016. The proportion of information actively provided by pharmacists was 43%. The most frequent information was in the area of infectious diseases, which accounted for 29% of the total. The acceptance rate was high in both surgeons and nurses. The antimicrobial use density (AUD)/days of therapy (DOT) of cefmetazole, an injectable antibacterial commonly used in the perioperative period, was increased significantly, suggesting that support for drug therapy by information providing is important in promoting the appropriate use of antimicrobial agents and playing a role in team medicine in multidisciplinary care.