[Bacterial nosocomial infections in urology: defective wound healing]

The highest incidence of defective wound healing in all surgical disciplines is observed after urological operations. Wound infections occur in more than 8% of all urological patients. Defective wound healing appears in about 17% of unselected nephrectomy cases, rising to 50% when pyonephrosis is present. Simple adenomectomy is associated with wound infection rates of between 8 and 12% in preoperatively uninfected patients and up to 50% in patients with preoperative bacteriuria. Numerous factors may influence wound healing, e.g. age, obesity, cachexia, chronic infectious and non-infectious diseases, anaemia, thrombopathy, faulty asepsis and antisepsis, preoperative showering and shaving, skin preparation, hand degerming, skin draping, duration of hospitalization, traumatic operative technique, suture material, diathermy, timing and length of operation, duration of hospitalization, and antibiotic regimen. Strict attention has to be paid to these factors if the incidence of postoperative wound infection is to be kept within reasonable limits.