Use of a Preoperative Checklist Reduces Risk of Penile Prosthesis Infection

Abstract

After an outbreak of an unusually high number of penile prosthesis infections, implementation of a required checklist brought the rate down to zero. Although the specific factors that led to the infection outbreak and subsequent cessation of infections are unknown, we have shown that use of a checklist was associated with a dramatic impact on patient safety.

Validated specific safety checklists for urological procedures can improve staff engagement and patient safety

“…A 22-item checklist has been developed specifically for use in conjunction with the WHO surgical safety checklist. 10 Katz et al 11 published a significant reduction in infected penile prostheses to 0% following the introduction of an evidence-based checklist to ensure that infection-preventing measures were carried out. Other checklists have been developed to reduce central line infections 12 and for the removal of all components of infected penile prostheses.…”

Infected penile prosthesis: literature review highlighting the status quo of prevention and management

“…This is not part of the consensus, but is in line with the WHO recommendation for preoperative preparations. In their publication of the checklist, they demonstrated that its application has reduced rates of IPPs [44].…”

Current Concepts in Infections Associated with Penile Prostheses and Artificial Sphincters

“…There has traditionally been a great variety in postoperative antibiotic management after prosthesis implantation, 30 and based on the expert opinion in the guideline, a 5-to 14-day course of oral antibiotics with trimethoprim-sulfamethoxazole (or doxycycline if the patient has a sulfa allergy) has been recommended. 28 Patient preparation Katz and colleagues 31 have shown that optimized blood sugar control (hemoglobin A 1c <10%) and a negative result of preoperative urine culture can reduce the risk of PP infection. A randomized controlled trial has shown a decreased incidence of surgical site infections by Staphylococcus aureus among patients who are nasal carriers with preoperative showering with chlorhexidine soap and the application of nasal mupirocin.…”

“…28 Intraoperative measures to decrease penileprosthesis-associated infections Soaking of the implant in rifampin/gentamicin solution, irrigating the wound before implantation with the same solution, handling of the device predominantly by the surgeon, and multilayered wound closure have been shown to contribute to the prevention of PP-associated infection. 31 It remains unclear whether the use of tissue glue to seal the wound is beneficial, and thus it cannot be recommended. 28 There is lack of evidence whether limiting traffic through the operating room during the procedure or leaving drains in place postoperatively has an impact on PPassociated infection risk.…”