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A NOVEL METHOD FOR EARLY DETECTION OF DEEP WOUND
INFECTION/DEHISCENCE IN BLADDER EXSTROPHY: POSTOPERATIVE SERIAL
NON-CONTACT INFRARED TEMPERATURE MEASUREMENT OF SURGICAL WOUND
Shabnam SABETKISH, Abdol-Mohammad KAJBAFZADEH, Nastaran SABETKISH and Sorena KEIHANI
Children's Hospital Medical Center, Pediatric Urology Research Center, Section of Tissue Engineering and Stem Cells
Therapy, Tehran, IRAN (ISLAMIC REPUBLIC OF)
PURPOSE
Surgical wound infection is a major risk factor for bladder dehiscence (BD) after bladder exstrophy surgery. This study
aims to introduce a practical method for early detection and management of surgical site infection and impending BD
after exstrophy surgery.
MATERIAL AND METHODS
Eleven exstrophy patients who underwent single stage reconstruction were enrolled. A non-contact digital infrared
temperature measurement device was used to measure temperatures on forehead and the surgical wound site prior,
during and after reconstruction. Temperatures were documented every 8 hours for 12 days postoperatively. Parents
were trained to measure the temperatures for two weeks following discharge. The same postoperative protocol was
applied for 13 hypospadias patients (group II) as the control group.
RESULTS
None of the patients in the hypospadias group developed local temperature rise during the postoperative follow-up.
However, two children with exstrophy developed temperature rise in the surgical wound area without rise in forehead
temperature. The wound site temperature reached 39.2˚C in one case and 39.4˚C in another at 12 and 16 days
postoperatively, respectively. Urine and wound cultures obtained at the time of temperature rise confirmed gram-
positive infection. After starting the appropriate antibiotic regimen, the wound temperatures gradually decreased.
CONCLUSIONS
Serial measurement of the surgical wound site temperature may be a promising method following exstrophy surgery.
This feasible technique might predict the occurrence of deep wound infection and help surgeons to prevent consequent
dehiscence and total wound opening before classic and visible signs and symptoms of wound infection occur.