RETRACTED: Effect of wound irrigation on the prevention of surgical site infections: A meta‐analysis

Abstract

We performed a meta‐analysis to evaluate the effect of wound irrigation on the prevention of surgical site infections. A systematic literature search up to January 2022 was done and 24 studies included 4967 subjects under surgery at the start of the study; antibiotic irrigation was used with 1372 of them, 1261 were aqueous povidone‐iodine irrigation, and 2334 were saline irrigation or no irrigation for surgical site infections prevention in all surgical populations. We calculated the odds ratio (OR) with 95% confidence intervals (CIs) to evaluate the effect of different wound irrigation on the prevention of surgical site infections by the dichotomous method with a random or fixed‐influence model. Antibiotic irrigation had significantly lower surgical site infections in all surgical populations (OR, 0.48; 95% CI, 0.36‐0.62, P < .001) compared with saline irrigation or no irrigation for the subject under surgery. Aqueous povidone‐iodine irrigation had significantly lower surgical site infections in all surgical populations (OR, 0.40; 95% CI, 0.20‐0.81, P = .01) compared with saline irrigation or no irrigation for the subject under surgery. Antibiotic irrigation and aqueous povidone‐iodine irrigation significantly lowered surgical site infections in all surgical populations compared with saline irrigation or no irrigation for the subject under surgery. Further studies are required.

Uncovering the Benefits of Povidone Iodine Compared to Other Therapeutic Agents in Wound Infection Prevention and Healing Outcomes: A Scoping Review

“… 35 In line with a previous meta-analysis, wound irrigation with antibiotics was effective in reducing the SII. 36 Antibiotics, such as vancomycin, are known for their cost-effectiveness and bactericidal activity against common microorganisms implicated in SSI. 37 However, some antibiotics, such as vancomycin, are not effective against most gram-negative bacteria.…”

Surgical site infection prevention in abdominal surgery: is intraoperative wound irrigation with antiseptics effective? Protocol for a systematic review and meta-analysis

“…antibiotic solutions). [8][9][10][11][12][13][14][15][16][17] In conclusion, although IOWI remains a very popular procedure among surgeons, the lack of its standardisation leads to heterogeneous clinical trials with controversial results, which is why definite recommendations on its use are still lacking. 8 11 12 18 19 Consequently, we recently conducted a large multicentre randomised controlled surgical trial (IOWISI trial, DRKS00012251) investigating if the prophylactic irrigation of the laparotomy-wound before skin closure using antiseptic polyhexanide solution or saline can reduce postoperative SSI rates after clean-contaminated, contaminated or septic abdominal procedures, the results of which will provide high-quality evidence regarding this practice.…”

“…and various no longer recommended irrigation solutions (eg. antibiotic solutions) 8–17. In conclusion, although IOWI remains a very popular procedure among surgeons, the lack of its standardisation leads to heterogeneous clinical trials with controversial results, which is why definite recommendations on its use are still lacking 8 11 12 18 19.…”

Comparing the Efficacy of Povidone-Iodine Versus Normal Saline in Laparotomy Wound Irrigation to Prevent Surgical Site Infections: A Meta-Analysis

“…The current study reports the evaluation of PVI's prophylactic role in reducing SSIs, which has demonstrated superiority over normal saline or nothing. Fu et al [ 43 ] reported a meta-analysis of 24 studies on 4967 subjects evaluating antibiotic solution irrigation, aqueous PVI, and saline irrigation. Again, it supported the use of PVI wound irrigation to reduce SSI incidence.…”