In the News
Postoperative wounds are typically kept dry and covered with a dressing until the sutures are removed to promote optimal wound healing and prevent infection. However, small studies have shown that patients with clean, superficial wounds can safely remove dressings and shower soon after surgery without negative consequences. Larger studies have been lacking, as have studies involving “clean-contaminated” wounds—incisions created for surgeries involving the gastrointestinal, genitourinary, or respiratory tracts.
Researchers from Taiwan studied wound infection rates, patients’ pain level and satisfaction with wound care, and the cost of wound care (assessed using the frequency of dressing changes and cost of materials used before the removal of sutures) in 440 surgical patients who had clean or clean-contaminated wounds related to surgery for thyroid goiter or cancer, lung tumor or cancer, inguinal hernia repair, or face or extremity tumors. Patients were randomly assigned to one of two groups: those who could shower after surgery, beginning after 48 hours and after any postsurgical drainage tubes were removed; and those who had to refrain from showering or bathing and who were instructed to change the dressing every day or two after cleaning with sterile saline solution. Wound care in the 48 hours after surgery was the same in both groups. Patients in the showering group were encouraged not to soak or rub their wounds and to use a clean, dry towel; the wounds were left uncovered until sutures were removed.
When the sutures were removed in both groups, four of the 220 patients in the showering group had mild wound infections, compared with six of the 220 in the control group. The difference wasn't statistically significant. Of the 440 patients, 196 had clean-contaminated wounds. Seven of the 10 patients with infections had clean-contaminated wounds, three of 97 (3.1%) patients in the showering group and four of 99 (4%) in the nonshowering group, suggesting that showering does not increase the risk of infection in clean-contaminated wounds.
Many more patients in the showering group than in the nonshowering group reported being satisfied or very satisfied with wound care. Pain scores were comparable in the two groups, and costs were higher in the nonshowering group. The authors conclude that showering after 48 hours can be permitted with clean or clean-contaminated postoperative wounds.—Joan Zolot, PA
Hsieh PY, et al. Ann Surg
2015 Dec 10 [Epub ahead of print].