Hirose Yasuhiko, Naiki Taku, Ando Ryosuke, Nakane Akihiro, Etani Toshiki, Iida Keitaro, Akita Hidetoshi, Okamura Takehiko, Kohri Kenjiro
Department of Nephro-Urology, Nagoya City University Graduate School of Medical Sciences, 1 Kawasumi, Mizuho-Cho, Mizuho-Ku, Nagoya 467-8601, Japan ; Department of Urology, J. A. Aichi Anjo Kosei Hospital, 28 Higashihirokute, Anjo-Cho, Anjo 446-0082, Japan.
Department of Urology, J. A. Aichi Anjo Kosei Hospital, 28 Higashihirokute, Anjo-Cho, Anjo 446-0082, Japan.
ISRN Urol. 2014 Mar 10;2014:897451. doi: 10.1155/2014/897451. eCollection 2014.
To reduce the incidence of surgical site infection (SSI) after radical cystectomy, a new closing method using subcutaneous continuous aspiration drain was developed and compared to the conventional closing method. The new method involved (a) closed aspiration with an indwelling aspiration drain without suture of the subcutaneous fat and (b) covering with hydrocolloid wound dressing after suture of the dermis with 4-0 absorbable thread and reinforcement using strips. The incidence of SSI was significantly improved by using the new method. Furthermore, univariate and multivariate analysis associated with SSI revealed that the new closing method was statistically correlated with 85% reduction of SSI (odds ratio: 0.15, 95% confidence interval: 0.03-0.69).Our new method using continuous aspiration with subcutaneous drain is useful for preventing SSI through removal of effusions and reduction of dead space by apposition of the subcutaneous fat.
为降低根治性膀胱切除术后手术部位感染（SSI）的发生率，研发了一种使用皮下持续负压引流的新闭合方法，并与传统闭合方法进行比较。新方法包括：（a）使用留置负压引流进行闭合吸引，不缝合皮下脂肪；（b）用4-0可吸收缝线缝合真皮后，覆盖水胶体伤口敷料并用条带加固。使用新方法后，SSI的发生率显著改善。此外，与SSI相关的单因素和多因素分析显示，新闭合方法与SSI降低85%具有统计学相关性（比值比：0.15，95%置信区间：0.03-0.69）。我们使用皮下引流持续吸引的新方法，通过清除积液和减少皮下脂肪贴合产生的死腔，有助于预防SSI。
