泌尿器科手術における術創の消毒の意義

著者らは泌尿器科手術の術創に対する頻回の消毒は不要であることを細菌学的に明らかにした.泌尿器科での手術を受けた症例(97例)を, 創部の消毒を行った群, 消毒を行わなかった群, 術直後のみ行った群で, 創処置別に3群に無作為に分けた.その結果, 1)3群間での創部感染に関する有意差はなかった. 2)創部の細菌数は術後の時間がたつごとに増加したが, 3群で同じ傾向であった. 3)分離菌では, 皮膚の常在菌の一種である表皮ブドウ球菌が最も多く, 3群間でもほぼ同様の頻度であった.以上, これらのことからも, 術後の創部の処置として, 汚染手術などの特殊な場合を除いて, 消毒しないで被覆しておくことは有効であり, 頻回の消毒は意味がないと考えられたThe objective of this study was to confirm that frequent disinfection by antiseptics is unnecessary on surgical wounds of urologic operations. Patients who received urologic operations were divided into 3 groups that had the same surgical dressings but different frequencies of disinfection and different antiseptics used. Surgical wounds were evaluated clinically and bacteriologically for the period until removal of sutures. Of the 97 patients randomly recruited for the study, 3 developed surgical-site infection (SSI). There was no significant difference in the incidence of SSI among the 3 groups. Bacterial counts of surgical wounds increased over time after operation, to similar extents in the 3 groups. The major isolate was Staphylococcus epidermidis, one of the normal florae on the skin. This strain was found at almost equal frequencies in all groups. In conclusion, our study suggested that covering with the surgical dressing without frequent disinfection by antiseptics was effective for prevention of SSI. Thus, traditional frequent disinfection should be abandoned