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Wound infection following vasectomy—a method of control
Abstracts
The role
of infection
in delayed K. G. Harding
Welsh National
School of Medicine,
125
healing
of open
wounds
and S. Bale
University Hospital Glamorgan, UK
of Wales, Heath
Park,
Cardiff,
South
We have been involved in the organization of a wound clinic set up to deal with granulating wounds that were suitable for treatment with silastic foam dressing. The clinic is now seeing in excess of 300 patients a year with a wide variety of underlying conditions. During this time we have noticed that certain wounds of a specific nature took much longer to heal than the normal rate for wounds of the same type and the granulation tissue present was abnormal in that it was friable, bled easily and superficial bridging was often present. In an attempt to identify the cause of this problem we looked specifically at wounds created after pilonidal sinus excision, laparotomy wounds that were healing by granulation and axillary excisions of hidradinitis suppurativa. We have found that in patients with delayed healing in virtually all cases studied a significant bacteriological culture was obtained. In the vast majority of cases these organisms were anaerobes usually of Bacteroides spp. but also in some cases Staphylococcus aureus was the major organism present. We have found that if these patients are given the appropriate antibiotic therapy, the organisms disappear, the granulation tissue changes in appearance to that which we normally see and the rate of wound healing increases. We feel that bacteriology of these wounds does play an important part in the management of patients with delayed healing of granulating wounds.
Wound
infection
P. E. Randall,
following L. A. Gamguli,
vasectomy-a
method
M. G. L. Keaney
Hope Hospital,
Salford,
and
of control
R. W. Marcuson
UK
A prospective study of wound infection following vasectomy in 94 patients, revealed a high overall wound infection rate of 32.9 per cent. A single pre-operative shower with either soap or chlorhexidine gluconate (‘Hibiscrub’ ICI) did not affect the infection rate, although the chlorhexidine significantly reduced the bacterial flora of the scrotum and perineum. The presence of an open, discharging w ound, whether purulent or serous, was considered clinically infected and swabs were sent for microbiological study. The presence of a wound haematoma and the nasal carriage of pathogenic organisms were associated with a significant increase in infection. Other factors, e.g. general or local anaesthetic, grade of surgeon, skin preparation used, suture material, duration of operation were not found to influence infection rate. However, a further prospective study showed that the use of a chlorhexidine gluconate shower on day one and day two postoperatively, resulted in an infection rate of 6.2 per cent in the treated group as compared to 37.8 per cent in the control group which had one preoperative chlorhexidine gluconate shower only (P< 0.01). This suggests that the addition of postoperative chlorhexidine gluconate showers is effective in reducing wound infections in vasectomy patients.
The role
of infection
in delayed K. G. Harding
Welsh National
School of Medicine,
125
healing
of open
wounds
and S. Bale
University Hospital Glamorgan, UK
of Wales, Heath
Park,
Cardiff,
South
We have been involved in the organization of a wound clinic set up to deal with granulating wounds that were suitable for treatment with silastic foam dressing. The clinic is now seeing in excess of 300 patients a year with a wide variety of underlying conditions. During this time we have noticed that certain wounds of a specific nature took much longer to heal than the normal rate for wounds of the same type and the granulation tissue present was abnormal in that it was friable, bled easily and superficial bridging was often present. In an attempt to identify the cause of this problem we looked specifically at wounds created after pilonidal sinus excision, laparotomy wounds that were healing by granulation and axillary excisions of hidradinitis suppurativa. We have found that in patients with delayed healing in virtually all cases studied a significant bacteriological culture was obtained. In the vast majority of cases these organisms were anaerobes usually of Bacteroides spp. but also in some cases Staphylococcus aureus was the major organism present. We have found that if these patients are given the appropriate antibiotic therapy, the organisms disappear, the granulation tissue changes in appearance to that which we normally see and the rate of wound healing increases. We feel that bacteriology of these wounds does play an important part in the management of patients with delayed healing of granulating wounds.
Wound
infection
P. E. Randall,
following L. A. Gamguli,
vasectomy-a
method
M. G. L. Keaney
Hope Hospital,
Salford,
and
of control
R. W. Marcuson
UK
A prospective study of wound infection following vasectomy in 94 patients, revealed a high overall wound infection rate of 32.9 per cent. A single pre-operative shower with either soap or chlorhexidine gluconate (‘Hibiscrub’ ICI) did not affect the infection rate, although the chlorhexidine significantly reduced the bacterial flora of the scrotum and perineum. The presence of an open, discharging w ound, whether purulent or serous, was considered clinically infected and swabs were sent for microbiological study. The presence of a wound haematoma and the nasal carriage of pathogenic organisms were associated with a significant increase in infection. Other factors, e.g. general or local anaesthetic, grade of surgeon, skin preparation used, suture material, duration of operation were not found to influence infection rate. However, a further prospective study showed that the use of a chlorhexidine gluconate shower on day one and day two postoperatively, resulted in an infection rate of 6.2 per cent in the treated group as compared to 37.8 per cent in the control group which had one preoperative chlorhexidine gluconate shower only (P< 0.01). This suggests that the addition of postoperative chlorhexidine gluconate showers is effective in reducing wound infections in vasectomy patients.