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开放性根治性前列腺切除术后的伤口处理及手术浅表部位感染

Postoperative wound dealing and superficial surgical site infection in open radical prostatectomy.

作者信息

Yamamichi Fukashi, Shigemura Katsumi, Yamashita Mauso, Tanaka Kazushi, Arakawa Soishi, Fujisawa Masato

机构信息

Division of Urology, Department of Organ Therapeutics, Faculty of Medicine, Kobe University Graduate School of Medicine, Kobe, Japan.

Department of Urology, Shinko Hospital, Kobe, Japan.

出版信息

Int Wound J. 2016 Oct;13(5):692-6. doi: 10.1111/iwj.12348. Epub 2014 Sep 4.

Abstract

The number of open radical prostatectomy (RP) surgeries has been decreasing owing to the spread of laparoscopic and robotic surgery, which has implications for postoperative wound healing. The purpose of this study was to investigate and document the current status of postoperative wound healing and superficial surgical site infection (SSI) in open RPs. One hundred and seventy-five antegrade RPs with the same or similar kinds of prophylactic antibiotic administration were divided into two groups: (i) 'no intervention' (wound covering group) and (ii) 'washing', using a washing solution from the second postoperative day to the day of skin staple removal (wound washing group). We compared these groups for the occurrence of superficial SSI. The wound covering group had three (3·03%) cases of superficial SSI, with one case caused by methicillin sensitive Staphylococcus aureus (MSSA). The wound washing group had nine (11·8%) cases of superficial SSI, with three cases caused by MSSA, two cases caused by methicillin resistant Staphylococcus aureus (MRSA) and one by Pseudomonas aeruginosa. The wound covering group showed a significantly lower ratio of superficial SSI (P = 0·0472). In conclusion, the postoperative wound status data in this study suggests that no wound intervention after RP resulted in a comparatively lower ratio of superficial SSI than in the wound washing group.

摘要

由于腹腔镜手术和机器人手术的普及,开放性根治性前列腺切除术(RP)的手术数量一直在减少,这对术后伤口愈合有一定影响。本研究的目的是调查并记录开放性RP术后伤口愈合及浅表手术部位感染(SSI)的现状。175例接受相同或相似种类预防性抗生素治疗的顺行性RP患者被分为两组:(i)“不干预”组(伤口覆盖组)和(ii)“冲洗”组,从术后第二天至皮肤钉拆除日使用冲洗液冲洗(伤口冲洗组)。我们比较了两组浅表SSI的发生率。伤口覆盖组有3例(3.03%)浅表SSI病例,其中1例由甲氧西林敏感金黄色葡萄球菌(MSSA)引起。伤口冲洗组有9例(11.8%)浅表SSI病例,其中3例由MSSA引起,2例由耐甲氧西林金黄色葡萄球菌(MRSA)引起,1例由铜绿假单胞菌引起。伤口覆盖组的浅表SSI发生率显著较低(P = 0.0472)。总之,本研究中的术后伤口状况数据表明,RP术后不进行伤口干预导致的浅表SSI发生率比伤口冲洗组相对较低。

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