[The prevention of infectious-inflammatory complications in operations on the kidney]

The paper presented the experience in the prevention of infectious complications during the renal surgery developed both in the organ operated on (acute postsurgical pyelonephritis) and in the surgical wound later. The package of prophylactic measures was employed in 48 patients operated on for the diseases of kidneys and urinary tract (nephrolithiasis predominantly). It included aseptic, antiseptic techniques, antibacterial treatment and preventive treatment in the pre-, intra- and postoperative periods, as well as intraoperative irrigation of the wound with antiseptic solutions and postoperative local therapy. Antibacterial prophylaxis was started 3-5 days or at night before the indicated surgery. Antibiotics were administered only after a careful adjustment of the dosage. Their intravenous (mainly) injections were performed under the effect of preliminary anesthetics. Clinical materials for microbiological and pharmacokinetic monitoring were being taken during the operation. Sodium chloride solution was electrolyzed and the obtained sodium hypochloride was used for the sanation of pyogangrenous foci. Patients with pyodestructive renal lesions developed in the presence of active chronic or acute pyelonephritis and the drainage of the urinary tract underwent 5-7-day antibacterial therapy. The aforementioned preventive measures allowed the authors to gain a significant reduction in the incidence of postoperative pyelonephritis (from 94.2 to 31.2 per cent) and wound infection (from 19.2 to 8.3 per cent), as well as bacteremia (from 32.3 to 5.4). Postsurgical complications (acute pyelonephritis and wound infection), if appeared, ran a relatively favorable course and were cured 3-5 days later. Uroseptic conditions were not observed.