Vol.60 No.2 March 2012
Prevention of surgical site infection after radical cystectomy
Department of Urology, Sapporo Medical University School of Medicine, S1,W16, Chuo-ku, Sapporo, Hokkaido, Japan
Abstract
Radical cystectomy with urinary diversion or reconstruction, one of the options for the treatment of bladder cancer, has relatively higher complication rates compared with other urological surgeries. One of the complications is surgical site infection(SSI) and the frequency of SSI is high in radical cystectomy with urinary diversion or reconstruction. Although the frequency of SSI with urinary diversion or reconstruction has been decreasing gradually, the current frequency is still too high to be generally acceptable.
There are guidelines for surgical antimicrobial prophylaxis to prevent SSI from the Japanese Urological Association(JUA), American Urological Association(AUA) and European Association of Urology(EAU), respectively. Those guidelines show that the duration of antimicrobial prophylaxis is less than 24 hours postoperation in the AUA and EAU and from 72 to 96 hours in the JUA. Second or 3rd generation cephalosporin is recommended in each guideline. However, the principal causative pathogen of SSI is methicillin resistant Staphylococcus aureus in Japan and that resistant pathogen makes the prevention of SSI difficult.
We review the current situation and future perspective of the proper management and adequate antimicrobial prophylaxis regimen for this operation with a high frequency of complications.
Key word
radical cystectomy, surgical site infection, prophylaxis
Received
January 5, 2012
Accepted
January 16, 2012
Jpn. J. Chemother. 60 (2): 169-174, 2012
