You have accessJournal of UrologyInfections/Inflammation of the Genitourinary Tract: Kidney & Bladder1 Apr 2012896 CONTINUOUS ASPIRATION WITH SUBCUTANEOUS DRAIN AND WOUND CLOSURE BY DERMAL SUTURE REDUCE SURGICAL SITE INFECTIONS, FOCUSED ON RADICAL CYSTECTOMY CASES Yasuhiko Hirose, Takehiko Okamura, Takahiro Kobayashi, Ryosuke Ando, Akihiro Nakane, Hidetoshi Akita, Hidenori Nishio, Yoshinobu Moritoki, and Kenjiro Kohri Yasuhiko HiroseYasuhiko Hirose Nagoya, Japan More articles by this author , Takehiko OkamuraTakehiko Okamura Anjo, Japan More articles by this author , Takahiro KobayashiTakahiro Kobayashi Anjo, Japan More articles by this author , Ryosuke AndoRyosuke Ando Anjo, Japan More articles by this author , Akihiro NakaneAkihiro Nakane Anjo, Japan More articles by this author , Hidetoshi AkitaHidetoshi Akita Anjo, Japan More articles by this author , Hidenori NishioHidenori Nishio Nagoya, Japan More articles by this author , Yoshinobu MoritokiYoshinobu Moritoki Nagoya, Japan More articles by this author , and Kenjiro KohriKenjiro Kohri Nagoya, Japan More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2012.02.992AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Although we have practiced strict infection control with such measures such as diligent hand washing before surgery, short-term administration of single antibiotics, application of dressings directly after surgery, and use of quick-drying alcoholic agents, these measures have not resulted in sufficient control of surgical site infections (SSI), especially radical cystectomy cases at our hospital. Therefore, we changed the method of closing surgical wounds in order to reduce SSI and performed a comparative review. METHODS The subjects of this review were 317 patients with conventional surgical wound closure, i.e. knotted sutures of absorbable thread for the subcutaneous fat followed by knotted sutures of nylon thread (for the skin from 2002 to 2007) and 41 patients with closure by the new method described below (from January 2010). The new method involved: (1) Closed aspiration with an indwelling 10Fr J-VAC Blake silicon drain without suture of the subcutaneous fat. (2) Covering with Karayahesive after suture of the dermis with 4-0 absorbable thread. Univariate statistical analyses of risk factor for SSI were conducted, including 80 radical cystectomy patients from June 2002 to Feburuary 2011. RESULTS The incidence of SSI at our hospital was high from 2002 to 2007 was 14.5%(46 / 317 patients), including radical cystectomy with urinary diversion to the intestinal tract cases (56%:14 / 25 patients).After changing the method of wound closure, only one case (2.4%) of SSI occurred among 41 patients, including 6 radical cystectomy cases with urinary diversion to the intestinal tract. Univariate analysis showed that the method of closing surgical wounds was statistical significance (p< 0.05). Compared with the new method, the odds ratio of conventional surgical wound closure for SSI was 6.70 (95%CI 0.81-54.7). CONCLUSIONS Continuous aspiration with a subcutaneous drain and the closure of surgical wounds with dermal suture is useful for preventing SSI through removal of effusions and reduction of dead space by apposition of the subcutaneous fat, even in radical cystectomy cases. © 2012 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 187Issue 4SApril 2012Page: e365 Advertisement Copyright & Permissions© 2012 by American Urological Association Education and Research, Inc.MetricsAuthor Information Yasuhiko Hirose Nagoya, Japan More articles by this author Takehiko Okamura Anjo, Japan More articles by this author Takahiro Kobayashi Anjo, Japan More articles by this author Ryosuke Ando Anjo, Japan More articles by this author Akihiro Nakane Anjo, Japan More articles by this author Hidetoshi Akita Anjo, Japan More articles by this author Hidenori Nishio Nagoya, Japan More articles by this author Yoshinobu Moritoki Nagoya, Japan More articles by this author Kenjiro Kohri Nagoya, Japan More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...