We describe an investigation of postoperative abdominal infectious complications and discuss two regimens for preoperative antibiotic bowel preparation in cases who underwent total cystectomy with ileal urinary diversion. Ten cases (28.6%) of 35 who had been operated developed abdominal infectious complications. Six showed abdominal wound infection, 2 showed intrapelvic abscess and 2 showed abdominal wound infection with intrapelvic abscess. Of the 19 strains of organisms isolated from the postoperative infections, 11 (57.9%) were anaerobic bacteria and the most commonly isolated bacteria was Bacteroides. A significantly lower incidence of postoperative infection was found in cases who had received tobramycin and vancomycin (0%) than in those who had received kanamycin alone (41.7%). These results indicate that anaerobic bacteria are the major contributors to postoperative infections following total cystectomy with ileal urinary diversion and that tobramycin-vancomycin prophylaxis greatly reduces the incidence of postoperative infections.

Keywords:
Postoperative infection, Bowel preparation, Antibiotic prophylaxis, Total cystectomy with ileal urinary diversion, Anaerobic bacteria
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© 1991 S. Karger AG, Basel
1991
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