Effect of a preoperative coating agent on postoperative skin tears in pancreatectomy

Postoperative skin tears are an underrecognized complication following pancreatectomy and often result from the removal of adhesive surgical drapes. Despite a negative impact on recovery, limited strategies are available for their prevention.

We retrospectively analyzed data for 348 patients who underwent pancreatectomy at our institution from April 2019 to December 2021. In this cohort, 71 patients had received a preoperative sterile coating agent (intervention group), and 277 patients had not (control group). The incidence, severity, and treatment duration of postoperative skin tears were compared between these 2 groups, and univariate and multivariate analyses were performed to identify risk factors. Propensity score matching also was conducted, and receiver operating characteristic curve analysis was used to evaluate operative time thresholds.

Skin tears occurred in 19.0% of patients. The incidence was significantly lower in the intervention group compared with the control group (9.9% vs 21.3%, P = .02). Multivariate and propensity score matching analyses identified a prolonged operative time and absence of coating agent as independent risk factors for tears. Treatment duration was significantly shorter in the intervention group (P = .03). Receiver operating characteristic analysis identified a longer threshold operative time for skin tear occurrence in the intervention group (673 minutes versus 656 minutes in the control group), suggesting improved skin tolerance.

A sterile preoperative coating agent significantly reduces the risk of postoperative skin tears following pancreatectomy and may improve skin tolerance during prolonged procedures. Clinical use of this agent should be considered in high-risk surgical patients.