Initial experiences of preventing local incision infection during sacral neuromodulation

Abstract

To explore the possibility of using comprehensive anti-infection method during sacral neuromodulation (SNM) operation to prevent postoperative loacal incision infection. SNM were performed for 23 patients (male 11 cases, and female 12 cases) who had intractable lower urinary tract dysfunction from January 2013 to Feburary 2015. During the treatment period (both in stage I and stage II), several steps were adopted to prevent local incision infection after operation, such as comprehensive skin disinfection, strict aseptic operating, intravenous infusion of antibiotics (cefoxitin or levofloxacin) prophylacticly at least 24 h, using sterile water to wash the incursion in operation and taking oral antibiotics anti-infection as supplemental after operation. At the meantime, microbiological examination was performed in the explanted tined leads , extension wire connection and local gluteal tissue. A total of 23 patients received SNM with local anesthesia, mean time of operation, hospitalization and test period were 1.5 h, 3.2 d and 37.1 d , respectively. All patients had no symptoms of clinical local infection after stage I test period and all incisions were healing with I/A standard. Eight patients were removed the inside electrodes because of poor effect at the end of test period with local anesthesia. Bacterial growth was not detected in all 8 patients of explanted tined leads and extension wire connection. And all 8 patients had their incision healed with I/A standard. Fifteen patients received implantable pulse generator (IPG) with local anesthesia. Mean time of operation was 63 min and mean time of hospitalization was 2.2 d. Among them , 10 patients' extension wire connection and loacal tissue were send to microbiological examination and no bacterial growth was found. All stage II incisions were healing with I/A standard. Perioperative comprehensive anti-infection method could prevent local incision infection after SNM.