Is Preoperative Antimicrobial Prophylaxis Necessary in Testicular Torsion Surgery? Results from the National Surgical...

Area of Science:

• Pediatric Surgery
• Surgical Outcomes Research
• Infectious Disease Prevention

Background:

• Testicular torsion surgery (TTS) is a critical pediatric urological emergency.
• Surgical antimicrobial prophylaxis (SAP) is commonly used to prevent postoperative complications.
• The efficacy of SAP in TTS has not been extensively studied using large-scale datasets.

Purpose of the Study:

• To evaluate the impact of surgical antimicrobial prophylaxis (SAP) on postoperative outcomes in patients undergoing testicular torsion surgery (TTS).
• To analyze complication rates, including surgical site infection (SSI), 30-day readmission, and 30-day reoperation.
• To utilize the National Surgical Quality Improvement Program Pediatric (NSQIP-P) database for comprehensive outcome assessment.

Main Methods:

• Retrospective analysis of the 2021-2023 NSQIP-P database for all TTS cases.
• Exclusion of patients with unrecorded SAP administration data (n=2,725).
• Comparison of postoperative events between patients who received SAP (+ SAP, n=322) and those who did not (- SAP, n=292).

Main Results:

• No surgical site infections (SSI) were observed in the + SAP group; however, there were instances of 30-day readmission and reoperation.
• In the - SAP group, one deep incisional SSI and readmission occurred, with no 30-day reoperations.
• Statistical analysis revealed no significant differences in primary outcomes (SSI, 30-day readmission, 30-day reoperation) between the SAP and no-SAP groups.

Conclusions:

• This is the first study to assess SAP's impact in torsion-reduction surgeries using the NSQIP-P database.
• Postoperative complication rates following TTS are generally low.
• The findings suggest limited utility of routine SAP for testicular torsion surgery, despite its continued use.