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【Objective】 To investigate the current status of incision sites to obtain intact specimens in laparoscopic nephrectomy by urologists in China, so as to provide reference for the standardized procedure. 【Methods】 During Jun.20, 2021 and Jul.4, 2021, more than 20 000 urologists in a WeChat group were surveyed with a questionnaire. The general data, incision sites and related complications were statistically analyzed. 【Results】 A total of 601 valid questionnaires were collected, covering urologists from 31 provinces, autonomous regions and municipalities. Surgical approaches: 68 urologists chose trans-abdominal approach, 432 chose posterior abdominal space approach, 101 chose both surgical approaches. Incision sites: 97 urologists chose lumbar transverse incision, 202 chose dorsal oblique incision of the waist, 119 chose ventral oblique incision, 93 chose the paramedian incision, 112 chose the lower abdominal oblique incision (Gibson), 11 chose the transverse lower abdominal incision (Pfannenstiel), 7 chose the median incision of the lower abdomen, 2 chose the median incision in the upper abdomen, 15 chose axillary midline direct incision; 399 chose to cut off the muscles, and 202 chose not to. Complications: 232 urologists reported pain after 2 weeks, 369 reported no pain; 325 reported numbness after 2 weeks, 276 reported no numbness; 66 reported incisional hernia, 535 reported no hernia. 【Conclusions】 Chinese urologists tend to choose retroperitoneoscopic nephrectomy and waist incision to obtain intact specimens. Transperitoneal laparoscopic nephrectomy has a variety of incisions for intact specimens. There is no standardized incision sites to obtain intact specimens.
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Objective To explore the clinical effect of subcutaneous negative pressure suction cosmetic suture with anti L incision in liver surgery.Methods A total of 140 patients who received liver surgery in general surgery department of our hospital from March 2015 to April 2016 were randomly selected,of which 70 cases received cosmetic suture with negative pressure drainage (observation group),the other 70 cases treated with conventional suture(control group).The repair times,the healing of the incision of two groups were observed and analyzed.Results Compared with the control group,the repair time and hospital stays of patients in observation group were significantly shorter than those of the control group,and the differences were statistically significant (P ＜ 0.01).Conclusion Cosmetic suture with negative pressure drainage is effective to shorten the repair time,reduce the incidence of incision fat liquefaction and infection,while ensuring the aesthetic level of the incision.
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Objective To investigate postoperative infection rates of patients with different types of incisions and different risk indexes of operation in a tertiary hospital in Chengdu City through carrying out targeted monitoring of surgical incision,in order to determine important interventions for infection control.Methods The data about operating rooms in the hospital monitored in this study was collected via the Donghua software electronic information system,and the situation of postoperative infection of incision wounds was analysed as well.Results Among the 1 331 cases of patients,the total infection rate of postoperative incisions was 0.60％.The type Ⅰ,type Ⅱ and type Ⅲl/Ⅳ incision infection rate was 0.31％,0.69％ and 1.78％,respectively.The infection rate of patients whose surgical risk score was 0,1 point and ≥2 points was 0.13％,0.84％ and 1.74 ％,respectively.By Fisher exact test,there were statistically significant differences in postoperative infection rates among patients with different types of surgical incision and those with different surgical risk index scores(P＜0.05).Conclusion The postoperative infection rates of patients with type Ⅲ/Ⅳ incision and those with surgical risk index score≥2 points are the highest.It is necessary to emphasize and strengthen the intervention on controlling postoperative infections,effectively reduce the postoperative infection rate through active monitoring,in order to improve the quality of medical hospital treatment and ensure patients'safety.
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OBJECTIVE To investigate pathogen distribution and drug resistance in infection of operative incision and provide the reference for clinical prevention and cure.METHODS Referring to National Rules of Operation in Clinical Laboratory,strains were isolated and identified,and drug-sensitivity test was performed by DADE BEHRING panel.RESULTS Among total 140 strains of pathogenic bacteria,the most were Gram-negative bacilli that accounted for 58.6%(82 strains),followed by Gram-positive cocci that accounted for 41.4%(58 strains).Staphylococcus aureus and Pseudomonas aeruginosa had the higher detection rate.The former was 29.3% and the latter was 27.1%.Among the total S.aureus,meticillin-resistant S.aureus(MRSA) accounted for 31.7%.Detection rate of extended-spectrum beta-lactamases(ESBLs) producing Escherichia coli and Klebsiella pneumoniae was 40.9%.CONCLUSIONS Effective measurement should be taken to prevent and control infection of operative incision.