Risk of Surgical Site Infections Reduced By Wound Irrigation With Antiseptic Solutions: Study

The findings back up CDC guidelines calling for antiseptic cleansing after surgery to prevent surgical site infections.

Surgical site infections are one of the commonly occurring complications following surgery, often resulting in significant medical expenses and an increased risk of long-term health problems, including death. However, the findings of a new study highlights how hospitals may be able to greatly reduce the risk with an antiseptic solution after surgery, instead of using an antibiotic solution.

There are different types of solutions hospitals may use for wound irrigation following surgery, which involves flushing the surgical site to prevent infections from developing over the days and weeks after the procedure.

In a study published late last month in the medical journal JAMA Surgery, a team of international researchers compared the outcomes from different types of incisional wound irrigation methods, finding that use of aqueous antiseptic solutions were so much better that they concluded hospitals should avoid antibiotic wound irrigation altogether.

Researchers analyzed data from 41 clinical trials, including more than 17,000 patients. The rate of surgical site infection was 7.7%, with 1,328 infections overall.

The study data indicated there was high-certainty evidence that using an antiseptic irrigation solution significantly reduced surgical site infections compared to not using an irrigation technique at all.

Comparatively, the data showed there was low-certainty evidence that using an antibiotic solution to clean the wound after surgery reduced surgical site infections. Using a saline solution for irrigation showed no significant reduction in infection rates compared to no irrigation.

“Results suggest that the use of antibiotic wound irrigation be avoided due to the inferior certainty of evidence for its outcome and global antimicrobial resistance concerns,” the researchers concluded.

Even though the antibiotic solution showed some evidence it might help reduce surgical wound infections, researchers emphasized that it is better to use the antiseptic solution for wound irrigation, because the evidence was much stronger that it helped reduce the likelihood of infection after surgery.

Researchers recommend antiseptic solutions should be the preferred method for cleaning surgical site infections.

The findings bolster surgical site infection prevention guidelines released by the U.S. Centers for Disease Control and Prevention (CDC) in 2017. In addition to preparation with alcohol-based solutions in the operating room, the guidelines called for patients to use antiseptic or antimicrobial showers both before and after surgery.

Other research indicates sending patients emails after surgery reminding them to adhere to postoperative instructions to take antiseptic showers also helps reduce the risk of surgical site infections.