Abstract
Surgical hand hygiene reduces the risk of surgical site infections (SSIs). SSIs are not considered an issue in endourological surgery, whereas febrile urinary tract infections (f-UTIs) and urological sepsis are becoming problematic. We wondered whether surgical hand hygiene is necessary for endourological surgery. Therefore, we aimed to evaluate the influence of surgical hand hygiene on f-UTI onset in endourological surgery by comparing procedures in which surgical hand hygiene with double gloving was used with those in which regular hand hygiene with double gloving was used between April 2016 and July 2020. In this prospective cohort study of 477 patients who underwent endourological surgeries, surgeons in the surgical hand hygiene and regular hygiene groups performed surgery on 259 and 218 patients, respectively. There was no significant difference in patient background, and multivariate analyses revealed no significant differences in f-UTI onset (odds ratio, 0.87; p = 0.74) between the two groups. In conclusion, regular hand hygiene with double gloving may be considered an alternative to surgical hand hygiene to prevent endourological f-UTIs, which could alter operational protocols for endourological surgery. Further studies are needed to validate our findings.
Highlights
Surgical hand hygiene reduces the risk of surgical site infections (SSIs)
A total of 477 patients were enrolled during this study period, comprising 194 patients who underwent transurethral resection of a bladder tumour (TURBT), 189 who underwent ureteroscopy for a stone (URS), and 93 who underwent endoscopic combined intrarenal surgery (ECIRS)
Multivariate analyses demonstrated that there was no significant association between surgical hand hygiene and the incidences of febrile urinary tract infections (f-UTIs), sepsis, and inflammatory markers (Tables 3 and 4)
Summary
We aimed to evaluate the influence of surgical hand hygiene on f-UTI onset in endourological surgery by comparing procedures in which surgical hand hygiene with double gloving was used with those in which regular hand hygiene with double gloving was used between April 2016 and July 2020. SSIs are not considered an issue in endourological surgery, whereas febrile urinary tract infections (f-UTIs) and urological sepsis are becoming problematic This situation raises the question whether hand sanitisation similar to that used in other surgical procedures is necessary. We aimed to evaluate the influence of surgical hand hygiene on f-UTI onset in endourological surgery through comparing procedures in which surgical hand hygiene had been used with those in which regular hand hygiene had been used This is the first study to analyse and report whether omitting surgical hand hygiene may increase SSI in endourological surgery
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