Prevention of surgical site infection after kidney transplantation using intraoperative polyhexanide antiseptic solution filling the bladder

Abstract

   Introduction. The purpose of the study. To reduce the incidence of wound complications after kidney transplantation (KT) by using intraoperative sanitation of the bladder cavity (ISBC).
   Materials and methods of research. The study included 90 patients who underwent KT from 2020 to 2021. At the first stage, we determined the frequency of wound infection (WI) and assessed the significance of risk factors for its development, at the second stage, we determined the presence of asymptomatic bacteriuria (AB) when placed on the waiting list and immediately before the operation for each observation. At the third stage, patients with AB (n = 34) were divided into two groups depending on the use of ISBC 0,2 % antiseptic solution based on polyhexanide.
   Treatment results. At the time of placement on the waiting list, AB was recorded in 42 / 90 patients (47 %), at the time of surgery – in 34/90 (38 %). WI developed in 13 / 90 (14 %) patients. When comparing the frequency of WI depending on the presence of AB, statistically significant differences were obtained (p = 0,027). In the first group of patients with AB, where ISBC was used, WI developed in 2 / 18 (11 %) patients, in the control group (without the use of ISBC), in 7 / 16 (44 %) patients. We have identified a trend towards a decrease in the frequency of RI with the use of ISBC (p = 0,052).
   Conclusion. ISBC with an antiseptic solution based on polyhexanide makes it possible to achieve the eradication of pathogenic flora in the urinary tract, which reduces the risk of contamination of the surgical wound and the development of WI.