The role of saline irrigation prior to wound closure in the reduction of surgical site infection: a systematic review and meta-analysis

Patient Safety in Surgery

Peter C. Ambe¹  Johannes Dörner²  Hubert Zirngibl²  Julian-Dario Rembe²  Tanja Rombey³  Dawid Pieper³ 

[1] Department of General Surgery, Visceral Surgery and Coloproctology, GFO Kliniken Rhein Berg Vinzenz-Pallotti-Hospital Bensberg;Department of Surgery, Helios University Hospital Wuppertal;Institute for Research in Operative Medicine, Faculty of Health, School of Medicine, Witten/Herdecke University;

关键词: Abdominal surgery;    Normal saline;    Surgical site infection;    Wound infection;    Wound irrigation;   

DOI  :  10.1186/s13037-020-00274-2

来源: DOAJ

【 摘 要 】

Abstract Background Surgical site infection (SSI) describes an infectious complication of surgical wounds. Although SSI is thought to be preventable, it still represents a major cause of morbidity and substantial economic burden on the health system. Wound irrigation (WI) might reduce the level of bacterial contamination, but current data on its role in reducing or preventing SSI is conflicting. Our aim was to investigate the effectiveness of WI with normal saline prior to wound closure for the reduction of SSI in patients undergoing abdominal surgery. Methods We conducted a systematic literature search in MEDLINE, EMBASE, and CENTRAL from inception to present, and cross-checked the reference lists of all included primary studies and relevant systematic reviews. (Quasi-) randomized controlled trials (RCTs) investigating the rate of SSI when using normal saline vs. no irrigation prior to wound closure following abdominal surgery were included. Primary outcome was the rate of SSI, secondary outcome the mean length of hospital stay (LOS). Results Four RCTs including a total of 1194 patients were included for analysis. All studies compared wound irrigation with normal saline with no wound irrigation prior to wound closure. Their risk of bias was moderate. The relative risk of developing a SSI was lower when wound irrigation with normal saline was performed prior to wound closure although the effect was not statistically significant (risk ratio 0.73, 95%-confidence level: 0.37 to 1.43). Similarly, there was no difference in the LOS amongst both intervention arms. Conclusion This systematic review could not identify an advantage for routine irrigation of abdominal wounds with normal saline over no irrigation prior to wound closure in preventing or reducing the rate of SSI. Systematic review registration PROSPERO registry number CRD42018082287 .

【 授权许可】

Unknown