Department of Nephro-urology, Nagoya City University Graduate School of Medical Sciences, 1 Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya, Aichi, 467-8601, Japan.
Department of Urology, Daido Hospital, Nagoya, Japan.
Sci Rep. 2020 Sep 3;10(1):14520. doi: 10.1038/s41598-020-71556-z.
Surgical hand hygiene reduces the risk of surgical site infections (SSIs). SSIs are not considered an issue in endourological surgery, whereas febrile urinary tract infections (f-UTIs) and urological sepsis are becoming problematic. We wondered whether surgical hand hygiene is necessary for endourological surgery. Therefore, we aimed to evaluate the influence of surgical hand hygiene on f-UTI onset in endourological surgery by comparing procedures in which surgical hand hygiene with double gloving was used with those in which regular hand hygiene with double gloving was used between April 2016 and July 2020. In this prospective cohort study of 477 patients who underwent endourological surgeries, surgeons in the surgical hand hygiene and regular hygiene groups performed surgery on 259 and 218 patients, respectively. There was no significant difference in patient background, and multivariate analyses revealed no significant differences in f-UTI onset (odds ratio, 0.87; p = 0.74) between the two groups. In conclusion, regular hand hygiene with double gloving may be considered an alternative to surgical hand hygiene to prevent endourological f-UTIs, which could alter operational protocols for endourological surgery. Further studies are needed to validate our findings.
手术手卫生可降低手术部位感染（SSI）的风险。SSI 不被认为是内窥镜手术的问题，而发热性尿路感染（f-UTI）和尿脓毒症正在成为问题。我们想知道手术手卫生对于内窥镜手术是否有必要。因此，我们旨在通过比较 2016 年 4 月至 2020 年 7 月期间，使用双手套的手术手卫生与常规手卫生加双手套的手术的手术程序，来评估手术手卫生对内窥镜手术中 f-UTI 发病的影响。在这项对 477 例接受内窥镜手术的患者进行的前瞻性队列研究中，手术手卫生组和常规卫生组的外科医生分别对 259 例和 218 例患者进行了手术。两组患者的背景无显著差异，多变量分析显示 f-UTI 发病（比值比，0.87；p=0.74）无显著差异。总之，使用双手套的常规手卫生可能可以替代手术手卫生来预防内窥镜 f-UTI，可以改变内窥镜手术的操作方案。需要进一步的研究来验证我们的发现。
