Japanese guidelines for prevention of perioperative infections in urological field

Abstract

For urologists, it is very important to master surgical indications and surgical techniques. On the other hand , the knowledge of the prevention of perioperative infections and the improvement of surgical techniques should always be considered. Although the prevention of perioperative infections in each surgical field is a very important issue, the evidence and the number of guidelines are limited. Among them, the preparation of guidelines has progressed , especially in gastrointestinal surgery. The Center for Disease Control and Prevention (CDC) proposed guidelines for the prevention of surgical site infections, which have been used worldwide. In urology, the original guidelines were different from those of general surgery, due to many endourological procedures and urine exposure in the surgical field. The Japanese Society of UTI Cooperative Study Group has thus framed these guidelines supported by The Japanese Urological Association. The guidelines consist of the following nine techniques: open surgeries, laparoscopic surgeries, transurethral resection of bladder tumor, ureterorenoscope and transurethral lithotripsy, transurethral resection of the prostate, prostate biopsy, cystourethroscope, pediatric surgeries in the urological field , and extracorporeal shock wave lithotripsy and febrile neutropenia. These are the first guidelines for the prevention of perioperative infections in the urological field in Japan. Although most of these guidelines were made using reliable evidence, there are parts without enough evidence. Therefore, if new reliable data is reported , it will be necessary for these guidelines to be revised in the future. Key words:Open surgery, Laparoscopic surgery, TUR, Prostate biopsy, Cystourethroscope, ESWL. I. General remarksUrological practice mainly consists of surgical procedures, since the field of urology is a division of surgery. Therefore, it is very important to master surgical indications and surgical techniques. On the other hand , the knowledge of the prevention of perioperative infections and the improvement of surgical techniques should always be considered. Although the prevention of perioperative infections in each surgical field is a very important issue, these evidences are limited and the number of guidelines is limited. Among them, the preparation of guidelines has progressed , especially in gastrointestinal surgery. The Center for Disease Control and Prevention (CDC) proposed guidelines for the prevention of surgical site infections), 1 which have been used worldwide. In urology, the original guidelines were different from those of general surgery, due to many endourological procedures and urine exposure in the surgical field. We have thus framed these guidelines supported by The Japanese Urological Association. I-I Definition and classification of perioperative infectionsA perioperative infection is defined as an infection that occurs within one month after an operation. These infections are divided into two groups: surgical site infections (SSIs) and remote i...

Comparison of Postoperative Infection between Robotic-Assisted Laparoscopic Prostatectomy and Open Radical Prostatectomy

“…POI was defined as operation-related infection within 30 days after surgery [8] and was classified according to CDC criteria as superficial incisional surgical site infection, deep incisional surgical site infection or organ/space surgical site infection [10]. …”

“…To prevent POI, prophylactic antibiotic administration (PAA) is generally used. The kinds of PAA and the duration of dosing are not fully investigated for the compliance of the guideline even though there are guidelines for this purpose [8,9]. The guideline was established by the evidence and on the contrary, the compliance for keeping it in daily clinics should be also checked.…”

Is short course of antimicrobial therapy for asymptomatic bacteriuria before urologic surgical procedures sufficient?

“…According to antimicrobial sensitivity test results a single dose of appropriate parenteral antibiotic was given to the patients 30 to 60 minutes before the surgical procedure. This drug-to-procedure time interval was determined according to prophylaxis guidelines [11,12]. Following a dose interval recommended by the manufacturer, a second dose was given to patients with a postoperative urinary catheter.…”

Risk Factors for Surgical Site Infection (SSI) after Urological Surgery: Incisional and Deep-organ/space Experience at Anjo Hospital

“…For prevention of SSI, attention should be focused particulary on perioperative care. Matsumoto, et al presented the Japanese guidelines for prevention of perioperative infection 11) . In their summary, they recommended shortening of the preoperative hospital stay, determining and treating urinary tract infections before surgery, and avoiding hair removal as preoperative care.…”