The No-Touch Technique adheres to many of the practices associated with standard surgical sterility. Patients are placed on an oral fluoroquinolone for three days prior to the procedure and instructed to scrub the lower abdomen and genitals twice daily with chlorhexidine soap. Vancomycin and gentamicin are administered intravenously two hours prior to the start of the procedure. The lower abdomen and genitals are shaved, followed by a 5 minutes chlorhexidine/alcohol (Chloraprep). Surgical drapes are placed, followed by a Vi drape over the genitalia; The penis and scrotum are delivered through a small fenestration of the Vi drape and a capped Foley catheter is inserted int the bladder. An incision is made in the penoscrotal raffe and the dissection is carried down through the through the subcutaneous tissues to the level of Bucks fascia. A Scott retractor is employed with blunt hooks to maintain exposure.
At this point, the No-Touch principles are employed. The procedure is halted and all of the surgical instruments used thus far, including the Bovie, are removed from the surgical field and considered contaminated. All surgical gloves are changed. The 3M #1012 drape is used to losely drape the operative field. A small fenestration is made in the drape and blunt hooks are used to retract and secure the cut edges of the drape to the edges of the skin incision.
Implantation of the device proceeds with the usual steps associated with a multi-component prosthesis, including the incision and dilation of the corpora; sizing and placement of the penile components; and placement of the pump in the scrotum and the reservoir in the retropubic space, all through the small fenestration in the #1012 drape. Injectable saline is used for irrigation in all cases. Once the corporotomies are closed and all of the tubing has been covered with a layer of Buck’s fascia, the drape is removed and the subcutaneous tissues and skin are closed.
N=1,927 IPP on virgin and revision patients between 2002 and 2010
Both manufacture's 3-piece IPP were used – approximately 2:1 Coloplast Titan: AMS
Patients were similar in age and comorbidilies
In 2002, non-coated implants were used and the remaining years infection retardant coated IPP were implanted
The last four years the No-Touch Technique was performed
Infection rates in the three groups were examined and subjected to statistical analysis
Coated implants plus No-Touch Technique