Franck Bruyere1,2, Adrian Pilatz3, Axelle Boehm4, Benjamin Pradere4,5, Florian Wagenlehner3, Maxime Vallee6,7. 1. Urologie, CHU Bretonneau, Tours, France. franck.bruyere@gmail.com. 2. Université François Rabelais de Tours, PRES Centre Val de Loire, Tours, France. franck.bruyere@gmail.com. 3. Clinic of Urology, Pediatric Urology and Andrology, Justus Liebig University, Giessen, Germany. 4. Urologie, CHU Bretonneau, Tours, France. 5. Université François Rabelais de Tours, PRES Centre Val de Loire, Tours, France. 6. Urologie, CHU La Miletrie, Poitiers, France. 7. INSERM U1070, "Pharmacologie des Anti-Infectieux", UFR Médecine-Pharmacie, Université de Poitiers, Pôle Biologie Sante, 1 rue Georges Bonnet, Bâtiment B36 TSA 51106 86073, Poitiers Cedex 9, France.
Abstract
PURPOSE: Urinary tract infections are amongst the most frequent nosocomial infections followed by surgical site infections (SSI). Antibiotic prophylaxis is only one way to reduce the risk of post-operative infection. Our aim was to establish a review of the literature on measures to reduce post-operative infections outside antibiotic prophylaxis. METHODS: We performed a review of the literature in February 2019 using Medline database to identify relevant studies published in the last 10 years. We arbitrarily decided to fix our limit to the 10 last years considering that the resistance rate of bacteria to antibiotics and the surgical technics evolve over time. This search identified 229 studies. We included 53 studies selected upon the title or the abstract. RESULTS: Forty-four studies were finally included. We evaluated the efficacy to prevent SSI by skin antisepsis, surgical hand hygiene and technique, type of surgeons' caps, preservation of normothermia, hair removal, increased oxygen delivery, wound protectors, bathing, normoglycemia and immunonutrition. CONCLUSIONS: Antibiotic prophylaxis represents one way to prevent SSI but various other measures should be known and considered by anesthesiologists and surgeons. Some measures to reduce post-operative infections are not clearly established yet and more studies are needed.
PURPOSE: Urinary tract infections are amongst the most frequent nosocomial infections followed by surgical site infections (SSI). Antibiotic prophylaxis is only one way to reduce the risk of post-operative infection. Our aim was to establish a review of the literature on measures to reduce post-operative infections outside antibiotic prophylaxis. METHODS: We performed a review of the literature in February 2019 using Medline database to identify relevant studies published in the last 10 years. We arbitrarily decided to fix our limit to the 10 last years considering that the resistance rate of bacteria to antibiotics and the surgical technics evolve over time. This search identified 229 studies. We included 53 studies selected upon the title or the abstract. RESULTS: Forty-four studies were finally included. We evaluated the efficacy to prevent SSI by skin antisepsis, surgical hand hygiene and technique, type of surgeons' caps, preservation of normothermia, hair removal, increased oxygen delivery, wound protectors, bathing, normoglycemia and immunonutrition. CONCLUSIONS: Antibiotic prophylaxis represents one way to prevent SSI but various other measures should be known and considered by anesthesiologists and surgeons. Some measures to reduce post-operative infections are not clearly established yet and more studies are needed.
Entities:
Keywords:
Infections; Surgery; Surgical site infection; Urology
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