Reviewer ’s report  
 
Title: Predictors of surgical site infection after pancreaticoduodenectomy  
 
Version: 2 Date: 20 Apr 2020  
 
Reviewer: Research Square Reviewer 1  
 
Reviewer's report:  
 
PEER REVIEWER ASSESSMENTS:  
 
OBJECTIVE - Full research articles: is there a clear objective that addresses one or several 
testable research questions? (Brief or other article types: is there a clear objec tive?)  
Yes - there is a clear objective  
 
DESIGN - Is the current approach (including controls and analysis protocols) appropriate for the 
objective?  
Yes - the approach is appropriate  
 
EXECUTION - Are the experiments and analyses performed with sufficient t echnical rigor to 
allow confidence in the results?  
Yes - experiments and analyses were performed appropriately  
 
STATISTICS - Is the use of statistics in the manuscript appropriate?  
Yes - appropriate statistical analyses have been used in the study  
 
INTERPR ETATION - Is the current interpretation/discussion of the results reasonable and not 
overstated?  
No - there are minor issues  
 
OVERALL MANUSCRIPT POTENTIAL - Has the author addressed your concerns sufficiently 
for you to now recommend the work as a technica lly sound contribution? If not, can further 
revisions be made to make the work technically sound?  
Probably - with minor revisions  
 
 
PEER REVIEWER COMMENTS:  
 
GENERAL COMMENTS: Most of my points have been addressed.  
 
REQUESTED REVISIONS:  
see section b  
 
 
 
ADDITIONAL REQUESTS/SUGGESTIONS:  
The authors have made a number of changes in accordance with the reviewers' comments. I have 
a couple of remaining minor concerns:  
1. With some of the newer sections inserted, have the english language reviewed.  
2. Page 4 on surgical skin prep, I would be explicit on what your local practice is ie do your 
patients shower before hand, what skin prep you use, use of steridrape etc. As these simple 
manoeuvres have a significant impact on SSI  
3. Change in practice overtime, aga in be precise. State change in feeding practice and technical 
change in PJ. I am assuming there has been no change in the incidence of SSI associated with 
these changes in practice?  
4. Table 6 should be regarded as an opportunity to summarise the world li terature. Consider 
adding other columns of data eg year of publication, single centre/multi, number of cases, nos of 
cancer/benign, reported incidence of SSI etc.  
5. The discussion on putting present report in the context of the world literature, needs mo re 
work. Itis an opportunity to state the points that are consistently found to be associated with SSI 
and where the literature is contradictory try to explain why eg differences in study design, case 
numbers, practice etc.  
 
 
Are the methods appropriate and well described?  
If not, please specify what is required in your comments to the authors.  
 
Yes 
 
Does the work include the necessary controls?  
If not, please specify which controls are required in your comments to the authors.  
 
Yes 
 
Are the conclusions drawn adequately supported by the data shown?  
If not, please explain in your comments to the authors.  
 
No 
 
Are you able to assess any statistics in th e manuscript or would you recommend an  
additional statistical review?  
If an additional statistical review is recommended, please specify what aspects require further  
assessment in your comments to the editors.  
 
I am able to assess the statistics  
 
Quality of written English  
Please indicate the quality of language in the manuscript:  
 
Needs some language corrections before being published  
 
Declaration of competing interests  
Please complete a declaration of competing interests, considering the following questions:  
 
1. Have you in the past five years received reimbursements, fees, funding, or salary from an  
organisation that may in any way gain or lose financially from the publication of this  
manuscript, either now or in the future?  
 
2. Do you hold an y stocks or shares in an organisation that may in any way gain or lose  
financially from the publication of this manuscript, either now or in the future?  
 
3. Do you hold or are you currently applying for any patents relating to the content of the  
manuscript?  
 
4. Have you received reimbursements, fees, funding, or salary from an organization that 
holds  or has applied for patents relating to the content of the manuscript?  
 
5. Do you have any other financial competing interests?  
 
6. Do you have any non -financial co mpeting interests in relation to this paper?  
 
If you can answer no to all of the above, write 'I declare that I have no competing interests' 
below.  If your reply is yes to any, please give details below.  
 
This reviewer has been recruited by a partner organization, Research Square. Reviewers with  
declared or apparent competing interests are not utilized for these reviews. This reviewer has  
agreed to publication of their comments online under a Creative Commons Attribution License  
attributed to Research Square and was paid a s mall honorarium for completing the review within 
a specified timeframe. Honoraria for reviews such as this are paid regardless of the reviewer  
recommendation.  
 
I agree  to the open peer review policy of the journal. I understand that my name will be included  
on my report to the authors and, if the manuscript is accepted for publication, my named report  
including any attachments I upload will be posted on the website alon g with the authors'  
responses. I agree for my report to be made available under an Open Access Creative Commons  
CC-BY license ( http://creativecommons.org/licenses/by/4.0/ ). I understand that any comments  
which I do not wish to be included in my named repor t can be included as confidential comments  
to the editors, which will not be published.  
 
I agree to the open peer review policy of the journal  
Reviewer ’s report  
 
Title: Predictors of surgical site infection after pancreaticoduodenectomy  
 
Version: 2 Date: 20 Apr 2020  
 
Reviewer: Research Square Reviewer 1  
 
Reviewer's report:  
 
PEER REVIEWER ASSESSMENTS:  
 
OBJECTIVE - Full research articles: is there a clear objective that addresses one or several 
testable research questions? (Brief or other article types: is there a clear objec tive?)  
Yes - there is a clear objective  
 
DESIGN - Is the current approach (including controls and analysis protocols) appropriate for the 
objective?  
Yes - the approach is appropriate  
 
EXECUTION - Are the experiments and analyses performed with sufficient t echnical rigor to 
allow confidence in the results?  
Yes - experiments and analyses were performed appropriately  
 
STATISTICS - Is the use of statistics in the manuscript appropriate?  
Yes - appropriate statistical analyses have been used in the study  
 
INTERPR ETATION - Is the current interpretation/discussion of the results reasonable and not 
overstated?  
No - there are minor issues  
 
OVERALL MANUSCRIPT POTENTIAL - Has the author addressed your concerns sufficiently 
for you to now recommend the work as a technica lly sound contribution? If not, can further 
revisions be made to make the work technically sound?  
Probably - with minor revisions  
 
 
PEER REVIEWER COMMENTS:  
 
GENERAL COMMENTS: Most of my points have been addressed.  
 
REQUESTED REVISIONS:  
see section b  
 
 
 
ADDITIONAL REQUESTS/SUGGESTIONS:  
The authors have made a number of changes in accordance with the reviewers' comments. I have 
a couple of remaining minor concerns:  
1. With some of the newer sections inserted, have the english language reviewed.  
2. Page 4 on surgical skin prep, I would be explicit on what your local practice is ie do your 
patients shower before hand, what skin prep you use, use of steridrape etc. As these simple 
manoeuvres have a significant impact on SSI  
3. Change in practice overtime, aga in be precise. State change in feeding practice and technical 
change in PJ. I am assuming there has been no change in the incidence of SSI associated with 
these changes in practice?  
4. Table 6 should be regarded as an opportunity to summarise the world li terature. Consider 
adding other columns of data eg year of publication, single centre/multi, number of cases, nos of 
cancer/benign, reported incidence of SSI etc.  
5. The discussion on putting present report in the context of the world literature, needs mo re 
work. Itis an opportunity to state the points that are consistently found to be associated with SSI 
and where the literature is contradictory try to explain why eg differences in study design, case 
numbers, practice etc.  
 
 
Are the methods appropriate and well described?  
If not, please specify what is required in your comments to the authors.  
 
Yes 
 
Does the work include the necessary controls?  
If not, please specify which controls are required in your comments to the authors.  
 
Yes 
 
Are the conclusions drawn adequately supported by the data shown?  
If not, please explain in your comments to the authors.  
 
No 
 
Are you able to assess any statistics in th e manuscript or would you recommend an  
additional statistical review?  
If an additional statistical review is recommended, please specify what aspects require further  
assessment in your comments to the editors.  
 
I am able to assess the statistics  
 
Quality of written English  
Please indicate the quality of language in the manuscript:  
 
Needs some language corrections before being published  
 
Declaration of competing interests  
Please complete a declaration of competing interests, considering the following questions:  
 
1. Have you in the past five years received reimbursements, fees, funding, or salary from an  
organisation that may in any way gain or lose financially from the publication of this  
manuscript, either now or in the future?  
 
2. Do you hold an y stocks or shares in an organisation that may in any way gain or lose  
financially from the publication of this manuscript, either now or in the future?  
 
3. Do you hold or are you currently applying for any patents relating to the content of the  
manuscript?  
 
4. Have you received reimbursements, fees, funding, or salary from an organization that 
holds  or has applied for patents relating to the content of the manuscript?  
 
5. Do you have any other financial competing interests?  
 
6. Do you have any non -financial co mpeting interests in relation to this paper?  
 
If you can answer no to all of the above, write 'I declare that I have no competing interests' 
below.  If your reply is yes to any, please give details below.  
 
This reviewer has been recruited by a partner organization, Research Square. Reviewers with  
declared or apparent competing interests are not utilized for these reviews. This reviewer has  
agreed to publication of their comments online under a Creative Commons Attribution License  
attributed to Research Square and was paid a s mall honorarium for completing the review within 
a specified timeframe. Honoraria for reviews such as this are paid regardless of the reviewer  
recommendation.  
 
I agree  to the open peer review policy of the journal. I understand that my name will be included  
on my report to the authors and, if the manuscript is accepted for publication, my named report  
including any attachments I upload will be posted on the website alon g with the authors'  
responses. I agree for my report to be made available under an Open Access Creative Commons  
CC-BY license ( http://creativecommons.org/licenses/by/4.0/ ). I understand that any comments  
which I do not wish to be included in my named repor t can be included as confidential comments  
to the editors, which will not be published.  
 
I agree to the open peer review policy of the journal  
Please review this paper.
user
Reviewer ’s report  
 
Title: Predictors of surgical site infection after pancreaticoduodenectomy  
 
Version: 2 Date: 20 Apr 2020  
 
Reviewer: Research Square Reviewer 1  
 
Reviewer's report:  
 
PEER REVIEWER ASSESSMENTS:  
 
OBJECTIVE - Full research articles: is there a clear objective that addresses one or several 
testable research questions? (Brief or other article types: is there a clear objec tive?)  
Yes - there is a clear objective  
 
DESIGN - Is the current approach (including controls and analysis protocols) appropriate for the 
objective?  
Yes - the approach is appropriate  
 
EXECUTION - Are the experiments and analyses performed with sufficient t echnical rigor to 
allow confidence in the results?  
Yes - experiments and analyses were performed appropriately  
 
STATISTICS - Is the use of statistics in the manuscript appropriate?  
Yes - appropriate statistical analyses have been used in the study  
 
INTERPR ETATION - Is the current interpretation/discussion of the results reasonable and not 
overstated?  
No - there are minor issues  
 
OVERALL MANUSCRIPT POTENTIAL - Has the author addressed your concerns sufficiently 
for you to now recommend the work as a technica lly sound contribution? If not, can further 
revisions be made to make the work technically sound?  
Probably - with minor revisions  
 
 
PEER REVIEWER COMMENTS:  
 
GENERAL COMMENTS: Most of my points have been addressed.  
 
REQUESTED REVISIONS:  
see section b  
 
 
 
ADDITIONAL REQUESTS/SUGGESTIONS:  
The authors have made a number of changes in accordance with the reviewers' comments. I have 
a couple of remaining minor concerns:  
1. With some of the newer sections inserted, have the english language reviewed.  
2. Page 4 on surgical skin prep, I would be explicit on what your local practice is ie do your 
patients shower before hand, what skin prep you use, use of steridrape etc. As these simple 
manoeuvres have a significant impact on SSI  
3. Change in practice overtime, aga in be precise. State change in feeding practice and technical 
change in PJ. I am assuming there has been no change in the incidence of SSI associated with 
these changes in practice?  
4. Table 6 should be regarded as an opportunity to summarise the world li terature. Consider 
adding other columns of data eg year of publication, single centre/multi, number of cases, nos of 
cancer/benign, reported incidence of SSI etc.  
5. The discussion on putting present report in the context of the world literature, needs mo re 
work. Itis an opportunity to state the points that are consistently found to be associated with SSI 
and where the literature is contradictory try to explain why eg differences in study design, case 
numbers, practice etc.  
 
 
Are the methods appropriate and well described?  
If not, please specify what is required in your comments to the authors.  
 
Yes 
 
Does the work include the necessary controls?  
If not, please specify which controls are required in your comments to the authors.  
 
Yes 
 
Are the conclusions drawn adequately supported by the data shown?  
If not, please explain in your comments to the authors.  
 
No 
 
Are you able to assess any statistics in th e manuscript or would you recommend an  
additional statistical review?  
If an additional statistical review is recommended, please specify what aspects require further  
assessment in your comments to the editors.  
 
I am able to assess the statistics  
 
Quality of written English  
Please indicate the quality of language in the manuscript:  
 
Needs some language corrections before being published  
 
Declaration of competing interests  
Please complete a declaration of competing interests, considering the following questions:  
 
1. Have you in the past five years received reimbursements, fees, funding, or salary from an  
organisation that may in any way gain or lose financially from the publication of this  
manuscript, either now or in the future?  
 
2. Do you hold an y stocks or shares in an organisation that may in any way gain or lose  
financially from the publication of this manuscript, either now or in the future?  
 
3. Do you hold or are you currently applying for any patents relating to the content of the  
manuscript?  
 
4. Have you received reimbursements, fees, funding, or salary from an organization that 
holds  or has applied for patents relating to the content of the manuscript?  
 
5. Do you have any other financial competing interests?  
 
6. Do you have any non -financial co mpeting interests in relation to this paper?  
 
If you can answer no to all of the above, write 'I declare that I have no competing interests' 
below.  If your reply is yes to any, please give details below.  
 
This reviewer has been recruited by a partner organization, Research Square. Reviewers with  
declared or apparent competing interests are not utilized for these reviews. This reviewer has  
agreed to publication of their comments online under a Creative Commons Attribution License  
attributed to Research Square and was paid a s mall honorarium for completing the review within 
a specified timeframe. Honoraria for reviews such as this are paid regardless of the reviewer  
recommendation.  
 
I agree  to the open peer review policy of the journal. I understand that my name will be included  
on my report to the authors and, if the manuscript is accepted for publication, my named report  
including any attachments I upload will be posted on the website alon g with the authors'  
responses. I agree for my report to be made available under an Open Access Creative Commons  
CC-BY license ( http://creativecommons.org/licenses/by/4.0/ ). I understand that any comments  
which I do not wish to be included in my named repor t can be included as confidential comments  
to the editors, which will not be published.  
 
I agree to the open peer review policy of the journal  
assistant