Surgical Site Infection
Conditions
Brief summary
The goal of this observational study is to contribute to a better understanding of the perioperative kinetics of intestinal microbial composition and association with surgical site infections. The main question this study aims to determine if: * Patients undergoing surgery develop transient intestinal dysbiosis * Such transient dysbiosis is associated with translocation to the systemic circulation and surgical site infection Patients undergoing elective abdominal surgery will be included prospectively. Informed consent will be obtained. From patients the following information and samples will be collected: * Perioperative: Baseline health data, nutrition data, measurement body composition, glucose monitoring * Intraoperatively: * Mucosal swabs * Blood from central venous catheter and portal vein * Mesenteric lymph node * Intestinal specimen * Bile * Subcutaneous biopsy * Postoperatively: * If a surgical site infection occurs samples from infected site
Interventions
OTHERNo Intervention
This is purely an observational study.
Sponsors
Insel Gruppe AG, University Hospital Bern
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Patients undergoing laparoscopic colorectal resection with anastomosis or patients undergoing duodeno-pancreatectomy. * Elective surgery * Informed consent * Age \> 18 years
Exclusion criteria
* Emergency surgery * Other surgery 30 days prior to surgery * BMI \<18 or \>50kg/m2 * Planed simultaneous second procedure with involvement of the intestinal tract * Cholestasis with cholangitis, hepatic disease (defined as cirrhosis Child B or C) or renal disease (acute or chronic renal failure defined as eGFR≤ 30ml/min) * Severe active enteritis or colitis, malabsorption, enteric infections * Pancreatitis
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Changes of the intestinal microbiome between start and end of surgery | Day 0 (Day of Surgery) | Score between PCA (principal components analysis) in the intestine between start (T1) and end (T2) of surgery. * Sampling: An intestinal specimen is dissected at start and end of elective pancreatic resections. * Processing: Samples are immediately processed for storage at -80° in glycerol. * Analysis: Quantification of total Biomass, DNA extraction, preparation of Bacterial DNA libraries, sequencing with Illumina system, downstream analysis, statistical analysis, principal components analysis (PCA) with all the samples is performed and the score is defined based on the distance between the two centers in PC1 and PC2 of T1 versus T2. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Bacterial taxonomy in the intestine | Day 0 (Day of Surgery) | Bacterial taxonomy in the intestine at start (T1) and end (T2) of surgery |
| Bacterial taxonomy MLN | Day 0 (Day of Surgery) | Bacterial taxonomy MLN end (T2) of surgery |
| Bacterial taxonomy mucosal swabs | Day 0 (Day of Surgery) | Bacterial taxonomy mucosal swabs at start (T1) and end (T2) of surgery |
| Bacterial taxonomy in the blood | Day 0 (Day of Surgery) | Bacterial taxonomy in the blood at start (T1) and end (T2) of surgery |
Countries
Switzerland
Contacts
PRINCIPAL_INVESTIGATORGuido Beldi
Department of Visceral Surgery and Medicine, Bern University Hospital
Outcome results
None listed