Contamination of Urological Wounds by Aerobic Bacteria

Abstract

The density of aerobic bacteria in the subcutaneous wound was quantified by the velvet pad rinse technique before (first stage) and after (second stage) opening of the bladder in 13 patients undergoing transvesical prostatectomy. Six patients had bacteria in the urine preoperatively (group A) and the same bacteria were isolated from bladder puncture during the operation and during second stage. Seven patients (group B) had sterile urine preoperatively and the bacteria isolated during first and second stage were commensals of the skin and the upper-respiratory tract. The bacterial density in group B was median 3.1 viable counts (v.c.) × 10⁻¹/cm² during first stage rising to median 4.7 v.c. × 10⁻¹/cm² during second stage, while group A showed an increase from median 4.3 v.c. × 10⁻¹/cm² during first stage to median 169,5 v.c. × 10⁻¹/cm² during second stage. The results of the study indicate the possibility of using selective antibiotic prophylaxis, with the relevant antibiotic for the bacteria isolated in the urine preoperatively, to reduce postoperative wound infection in urological surgery with opening of the urinary bladder.