Effect of washing closed head and neck wounds on wound healing and infection

Goldberg, Herbert M.; Rosenthal, S. A.; Nemetz, Joseph C.

doi:10.1016/0002-9610(81)90196-3

Cited by 36 publications

(9 citation statements)

References 3 publications

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“…Patients in the wet group were asked to apply topical antibiotic following washes which might have considerably confounded these data. Again, no sensitivity analysis was performed in this study [4] . Noe and Keller report similar results in a case series of 100 consecutive patients undergoing skin excisions.…”

Section: Discussionmentioning

confidence: 99%

Postoperative washing of sutured wounds

Harrison

Wade

Gore

2016

Annals of Medicine &Amp; Surgery

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A best evidence topic was written according to the structured protocol. The three part question addressed was: [In patients undergoing closure of surgical wounds with sutures] does [keeping the wound dry for the first 48 h after closure] [reduce the incidence of surgical site infections (SSIs)]? 4 relevant papers were culled from the literature and appraised. The authors, date, country, population, study type, main outcomes, key results and study weaknesses were tabulated. Current NICE guidelines recommend cleaning surgical wounds with sterile saline only for the first 48 h following skin closure. We found no evidence that washing wounds with tap water during this period increases the incidence of SSIs compared to keeping them dry. Further randomised controlled trials will enable the construction of conclusive systematic reviews and meta-analyses.

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Section: Discussionmentioning

confidence: 99%

Postoperative washing of sutured wounds

Harrison

Wade

Gore

2016

Annals of Medicine &Amp; Surgery

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“…We initially identified a total of 1801 unique published studies via the search methods detailed above and finally included 11 eligible trials in the meta-analysis, all of which reported surgical site infection ( 5 , 8 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 ). The reference flow is shown in Fig.…”

Section: Resultsmentioning

confidence: 99%

“…However, guidance issued by an expert panel at the U.S. National Institutes of Health (NIH) states that it is relatively safe to bathe the epidermis and cover the wound within 48 h of wound closure ( 3 ). Furthermore, studies have found that earlier postoperative bathing does not increase the risk of suturing wound infection compared with bandaging without bathing ( 4 , 5 , 6 ).…”

Section: Introductionmentioning

confidence: 99%

Does earlier bathing increase the risk of surgical site infection? A meta-analysis of 11 randomized controlled trials

Ren,

Yu,

Wang

et al. 2024

EFORT Open Reviews

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Purpose For many decades, patients recovering from wound closure have been instructed not to bathe. Although studies have shown that earlier postoperative bathing does not increase the risk of wound infection, it remains rare in practice for patients to be allowed earlier postoperative bathing. We performed this meta-analysis to determine how earlier bathing affected rates of wound infection, other complications, and patient satisfaction. Methods This systematic review conforms to PRISMA guidelines. The PubMed, EMBASE, Medline, Web of Science, and the Cochrane Central Register of Controlled Trials were searched from their inception dates to December 31, 2022. We estimated pooled values for the efficacy of trial of earlier bathing versus delayed bathing using the odds ratio and their associated 95% CI, and we used the I 2 statistic to assess heterogeneity between studies contributing to these estimates. Results Of the 1813 articles identified by our search, 11 randomized controlled trials including 2964 patients were eligible for inclusion. The incidence of wound infection did not differ significantly between the earlier bathing and delayed bathing groups, nor did rates of other wound complications such as redness and swelling, or wound dehiscence. However, the incidence of hematoma in the delayed bathing group was higher than in the earlier bathing group. Reported patient satisfaction was significantly higher in the earlier bathing group. Conclusion The medical community, health authorities, and government should create and disseminate clinical practice guidelines to guide patients to evidence-based beneficial treatment.

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“…The possibility of treating wounds with tap water based on a prospective study was initially stated by Goldberg et al, who analyzed the effect of water on sutured wounds in the head or neck [17]. Currently, the discussion of whether to use tap water for surgically closed wounds no longer exists, and it is well accepted to use tap water for closed wounds as early as 48 h postoperatively [18].…”

Section: Discussionmentioning

confidence: 99%

“…The literature remains inconsistent concerning reinfection rates in surgically drained abscesses. Based on findings from prospective trials [17][18][19][20] we performed a sample size calculation for a noninferiority approach. Totally, 58 patients were in each treatment arm which equals a total of 116 patients needed to be include.…”

Section: Sample Sizementioning

confidence: 99%

Simple Wound Irrigation in the Postoperative Treatment for Surgically Drained Spontaneous Soft Tissue Abscesses: A Prospective, Randomized Controlled Trial

et al. 2020

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Background Soft tissue abscesses are among the most frequently encountered medical problems treated by different surgeons. Standard therapy remains incision and drainage with sterile saline irrigation during postoperative wound healing period. Aim of this prospective randomized controlled trial was to compare sterile irrigation versus nonsterile irrigation. Study design A single center randomized controlled trial was performed to investigate postoperative wound irrigation. The control group used sterile irrigation, and the intervention group used nonsterile irrigation. Primary endpoints were reinfection and reintervention rates, assessed during follow‐up controls for up to 2 years. Secondary endpoints were the duration of wound healing, inability to work, pain and quality of life. Results Between 04/2016 and 05/2017, 118 patients were randomized into two groups, with 61 allocated to the control‐ and 57 to the intervention group. Reinfection occurred in a total of 4 cases (6.6%) in the sterile protocol and 4 (7%) in the nonsterile protocol. Quality of life and pain values were comparable during the wound healing period, and patients treated according to the nonsterile irrigation protocol used significantly fewer wound care service teams. Despite equal wound persistence rates, a substantially shorter amount of time off from work was reported in the nonsterile protocol group (p value 0.086). Conclusion This prospective, randomized trial indicates that a nonsterile irrigation protocol for patients operated on for soft tissue abscesses is not inferior to the standard sterile protocol. Moreover, a nonsterile irrigation protocol leads to a shorter period of inability to work with comparable pain and quality of life scores during the wound healing period.

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Effect of washing closed head and neck wounds on wound healing and infection

Cited by 36 publications

References 3 publications

Postoperative washing of sutured wounds

Postoperative washing of sutured wounds

Does earlier bathing increase the risk of surgical site infection? A meta-analysis of 11 randomized controlled trials

Simple Wound Irrigation in the Postoperative Treatment for Surgically Drained Spontaneous Soft Tissue Abscesses: A Prospective, Randomized Controlled Trial

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