Does postoperative showering or bathing of a surgical site increase the incidence of infection? A systematic review of the literature.

Infection is one of the many postoperative complications a surgeon must attempt to control during the perioperative period. Surgeons have used a variety of modalities to prevent surgical site infection and have adhered to a variety of protocols. It has been common for foot and ankle surgeons to recommend that a patient keep the surgical incision covered and dry and to instruct the patient to avoid bathing and showering until the sutures have been removed. Surgeons have theorized that this will reduce contamination of the surgical site and help to prevent infection. We questioned the evidence basis for this practice and undertook a systematic review of electronic databases and other relevant sources regarding the incidence of infection when patients had been allowed to wet their surgical incision site by showering or bathing before suture removal. Nine studies involving 2150 patients met our inclusion criteria. No increased incidence of infection was found in the patients allowed to shower or bathe as a part of their normal daily hygiene before suture removal compared with those who were instructed to keep the site dry until suture removal.