N B Borkar1, M V Khubalkar. 1. Department of Surgery, AVBRH Sawangi, Wardha, Maharashtra, India. drnitinborkar25@gmail.com
Abstract
OBJECTIVE: To determine whether or not the routine use of postoperative dressings prevents surgical site infection and wound dehiscence. MATERIAL AND METHODS: Patients with clean or clean-contaminated (e.g. hernia, orchidectomy cystolithotomy, ureterolithotomy, appendectomy) sutured surgical wounds were randomised into two groups: those who did not receive postoperative dressings (the study group) and those who did (the control group). Variables like adequate haemostasis, sterile techniques, obliteration of all wound cavities, and approximation of divided structures were not controlled for. Wounds were assessed after 6 and 24 hours, and on the third and fifth postoperative days for clinical signs of infection and dehiscence. RESULTS: A total of 123 patients with 124 clean surgical wounds were recruited into the study. The mean age and ratio of men and women in each group were comparable. There was no significant difference in the rate of wound complications between the two groups: 4.76% for the study group and 4.92% for control. CONCLUSION: Based on these preliminary data, surgical wounds left open do not have an increased incidence of surgical site infection and wound dehiscence, compared with similar types of wounds dressed postoperatively. In a large teaching hospital, the extrapolated cost savings of dressing materials alone can be significant. Larger studies are needed to confirm these results. CONFLICT OF INTEREST: None.
RCT Entities:
OBJECTIVE: To determine whether or not the routine use of postoperative dressings prevents surgical site infection and wound dehiscence. MATERIAL AND METHODS:Patients with clean or clean-contaminated (e.g. hernia, orchidectomy cystolithotomy, ureterolithotomy, appendectomy) sutured surgical wounds were randomised into two groups: those who did not receive postoperative dressings (the study group) and those who did (the control group). Variables like adequate haemostasis, sterile techniques, obliteration of all wound cavities, and approximation of divided structures were not controlled for. Wounds were assessed after 6 and 24 hours, and on the third and fifth postoperative days for clinical signs of infection and dehiscence. RESULTS: A total of 123 patients with 124 clean surgical wounds were recruited into the study. The mean age and ratio of men and women in each group were comparable. There was no significant difference in the rate of wound complications between the two groups: 4.76% for the study group and 4.92% for control. CONCLUSION: Based on these preliminary data, surgical wounds left open do not have an increased incidence of surgical site infection and wound dehiscence, compared with similar types of wounds dressed postoperatively. In a large teaching hospital, the extrapolated cost savings of dressing materials alone can be significant. Larger studies are needed to confirm these results. CONFLICT OF INTEREST: None.
Authors: Jo C Dumville; Trish A Gray; Catherine J Walter; Catherine A Sharp; Tamara Page; Rhiannon Macefield; Natalie Blencowe; Thomas Kg Milne; Barnaby C Reeves; Jane Blazeby Journal: Cochrane Database Syst Rev Date: 2016-12-20