Advanced Urological Care, PC, New York, NY, USA.
Sex Med Rev. 2016 Jul;4(3):294-300. doi: 10.1016/j.sxmr.2016.01.002. Epub 2016 Apr 5.
Over 25% of the more than 725,000 cases of nosocomial infection in the United States are related to an implantable device. Despite the standard typical strategies available, infection rates for breast implants, cerebrospinal shunts, and penile implants remain unacceptably high. This paper will review use of a "no-touch" technique in varied surgical procedures from orthopedic fracture repair, cerebrospinal fluid shunt placement, and breast reconstruction/augmentation to penile prosthesis implantation.
One of our aims was to investigate whether the "no-touch" concept was unique to the field of penile implants and if similar results were obtained in other subspecialties. The other was to examine whether the low infection rate initially obtained with the "no-touch" technique was maintained for a larger number of penile implant procedures.
The literature was reviewed for the use of the "no-touch" technique in procedures as varied as orthopedic fracture repair, cerebrospinal fluid shunt placement, breast reconstruction/augmentation, and penile prosthesis implantation. In addition, a single surgeon's experience with 3342 penile implant surgeries with and without the use of the "no-touch" technique was reviewed.
Penile implant infection rate was examined for 3342 consecutive cases between January 2002 and December 2014. Infection of standard technique was compared with rate of infection with antibiotic impregnated devices and starting in 2006 with the addition of the "no-touch" enhancement.
Literature review revealed that the "no-touch" technique decreased postoperative cerebral shunt infection from 9.1% to 2.9%. Breast implant reconstruction surgical site infection decreased from 19% to none with the "no-touch" technique. Penile implant infection rate fell from 5.3% in 2002 to 1.99% with the use of antibiotic impregnated devices and to 0.44% with the addition of the "no-touch" technique.
Use of a "no-touch" technique involving a mechanical barrier makes a difference in preventing infection of an implantable device.
在美国超过 725000 例医院获得性感染中，超过 25%与植入装置有关。尽管有标准的典型策略可用，但乳房植入物、脑脊髓液分流器和阴茎植入物的感染率仍然高得令人无法接受。本文将回顾在骨科骨折修复、脑脊髓液分流器放置、乳房重建/增大以及阴茎假体植入等各种手术中使用“无接触”技术的情况。
我们的目的之一是研究“无接触”概念是否仅适用于阴茎植入物领域，以及在其他亚专科是否获得类似结果。另一个目的是检查在更大数量的阴茎植入手术中，最初采用“无接触”技术获得的低感染率是否得到维持。
对文献进行了回顾，以了解“无接触”技术在骨科骨折修复、脑脊髓液分流器放置、乳房重建/增大和阴茎假体植入等各种手术中的应用。此外，还回顾了一位外科医生在 2002 年 1 月至 2014 年 12 月期间进行的 3342 例阴茎植入手术中使用和不使用“无接触”技术的经验。
对 3342 例连续病例的阴茎植入感染率进行了检查。比较了标准技术感染率与抗生素浸渍器械感染率，并于 2006 年开始增加“无接触”增强技术。
文献综述显示，“无接触”技术将术后脑分流器感染率从 9.1%降至 2.9%。乳房植入物重建手术部位感染率从 19%降至“无接触”技术时的 0%。阴茎植入物感染率从 2002 年的 5.3%降至使用抗生素浸渍器械时的 1.99%，并在增加“无接触”技术时降至 0.44%。
使用涉及机械屏障的“无接触”技术可在预防植入装置感染方面产生差异。
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