皮下引流之根除性膀胱切除合併原位性膀胱重建手術傷口感染預防的效果
高耀臨、歐建慧、楊文宏、鄭鴻琳
國立成功大學醫學院附設醫院 泌尿部
Subcutaneous drain for the prevention of wound infection after radical cystectomy with orthotopic neobladder reconstruction
Yao-Lin Kao, Chien-Hui Ou, Wen-Horng Yang, Hong-Li Chen
Department of Urology, National Cheng Kung University Hospital, Taiwan
Purpose: Surgical site infection (SSI) for Open Radical Cystectomy (ORC) with intestinal Urinary diversion was relative high. Subcutaneous drainage (SD) for SSI prevention in previous studies in general kinds of wound showed no obvious benefit. However, in condition that are high risk for SSI such as increase thickness of subcutaneous fat (TSF), contaminated operation SD offer advantage somehow. We compare SSI rate in patients underwent ORC plus orthotopic neobladder reconstruction with SD and without SD.
Materials and Methods: Starting from in January 2012, 18 patients underwent ORC plus orthotopic neobladder reconstruction at the Department of Urology, National Cheng Kung University Hospital, Tainan Taiwan. The clinical features of these cases with or without a subcutaneous drain were reviewed.
Results: There were 13 patient underwent ORC plus orthotopic neobladder reconstruction without SD and 5 patient with SD. SSI rate was 23 % (3 out of 13) in no SD group and 0 % in SD group(0 out of 5). The SD indwelling duration rage from 7 days to 17 days (mean 8 days) with total amount range from 65ml to 124 ml ( mean: 96ml).
Conclusions: SD seems beneficial for SSI prevention in patients underwent ORC plus orthotopic neobladder reconstruction. However, due to small case number of our study, recruitment of patients with SD was still progressing. Further statistics analysis would done when there is ample of data.