You have accessJournal of UrologyInfections/Inflammation of the Genitourinary Tract: Kidney & Bladder1 Apr 20111177 LONG-TERM ASPIRATION WITH SUBCUTANEOUS DRAIN AND WOUND CLOSURE BY DERMAL SUTURE REDUCE SURGICAL SITE INFECTIONS Yasuhiko Hirose, Ryosuke Ando, Akihiro Nakane, Hidetoshi Akita, Takehiko Okamura, Yoshinobu Moritoki, and Hidenori Nishio Yasuhiko HiroseYasuhiko Hirose anjyo, Japan More articles by this author , Ryosuke AndoRyosuke Ando anjyo, Japan More articles by this author , Akihiro NakaneAkihiro Nakane anjyo, Japan More articles by this author , Hidetoshi AkitaHidetoshi Akita anjyo, Japan More articles by this author , Takehiko OkamuraTakehiko Okamura anjyo, Japan More articles by this author , Yoshinobu MoritokiYoshinobu Moritoki Nagoya, Japan More articles by this author , and Hidenori NishioHidenori Nishio Nagoya, Japan More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2011.02.789AboutPDF 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) 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 30 patients with closure by the new method described below (from January 2010). The new method involved: Closed aspiration with an indwelling 10F J-VAC Blake silicon drain without suture of the subcutaneous fat. Covering with Karayahesive after suture of the dermis with 4-0 absorbable thread. RESULTS The incidence of SSI at our hospital was high from 2002 to 2007, including 46 / 317 patients (14.5%) having laparotomy and 14 / 25 patients (56%) undergoing total cystectomy with urinary diversion to the intestinal tract. After changing the method of wound closure, no cases of SSI occurred among 30 patients, including 3 who had total cystectomy with urinary diversion to the intestinal tract. CONCLUSIONS Long-term aspiration with a subcutaneous drain and the closure of surgical wounds with dermal sutures are useful for preventing SSI through removed of effusions and reduction of dead space by apposition of the subcutaneous fat. Table 1. The incidence of SSI at our hospital from 2002 to 2007 Radical retropubic prostatectomy 4/120 Nephrectomy 9/123 total cystectomy with cutaneous ureterostomy 7/14 total cystectomy with urinary diversion to the intestinal tract 13/22 total cystectomy with neobladder 1/3 Table 2. The incidence of SSI at our hospital in 30 patients with closure by the new method from January 2010 Radical retropubic prostatectomy 0/11 Nephrectomy 0/8 partial nephrectomy 0/4 total cystectomy with cutaneous ureterostomy 0/1 total cystectomy with urinary diversion to the intestinal tract 0/3 others 0/3 © 2011 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 185Issue 4SApril 2011Page: e472 Advertisement Copyright & Permissions© 2011 by American Urological Association Education and Research, Inc.MetricsAuthor Information Yasuhiko Hirose anjyo, Japan More articles by this author Ryosuke Ando anjyo, Japan More articles by this author Akihiro Nakane anjyo, Japan More articles by this author Hidetoshi Akita anjyo, Japan More articles by this author Takehiko Okamura anjyo, Japan More articles by this author Yoshinobu Moritoki Nagoya, Japan More articles by this author Hidenori Nishio Nagoya, Japan More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...