Comparison of Early Versus Delayed Showering on Post-Operative Wound Infections
DOI:
https://doi.org/10.51985/RSCP2625Keywords:
Clean and contaminated surgeries, Surgical site infection, Postoperative bathAbstract
Objectives: To compare frequency of SSIs with and without early showering after clean and clean contaminated surgical
wounds.
Study Design and Setting: Randomized controlled trial was conducted at Department of Surgery. HIT Hospital, Taxila
from June 2020 to December 2020.
Methodology: A total of 130 participants were recruited after taking informed consent. After clean and clean-contaminated
surgery, first group was subjected to early showering (48 hours after surgery) while second group was not allowed showering
until removal of stiches. Both groups were compared in terms of SSIs. Data was entered into SPSS version 25. The mean
and standard deviation were used for the expression of continuous variables while frequency and proportion were used
for qualitative variables. Both groups were compared by independent sample t test and chi square test. A p value of <0.05
was considered statistically significant.
Results: The mean age of the patients was 39.92 ± 11.42 years and there was male gender dominancy i.e. 74 (56.9%) were
males while 56 (43.1%) were females. Clean surgeries were 81 (62.3%) and clean-contaminated proportion was 49 (37.7%).
Collectively, 12 (9.2%) patients developed SSIs during clinical followup. There was no difference between groups in terms
of age, gender, and wound types (p values 0.680, 0.157 and 0.587 respectively). In shower group, 3 (4.6%) and in nonshower
group, 9 (13.8%) patients developed SSIs (p value 0.069).
Conclusion: Early postoperative showering can be implemented safely in clean and clean contaminated surgical wounds
to minimize SSIs. The results should be evaluated in large RCTs.
References
Zolot J. Showering Is Safe 48 Hours After Surgery with Some
Wounds. Am J Nurs. 2016;116(4):16. doi:10.1097/01.
NAJ.0000482129.51435.d2
Feilmeier M, Dayton P, Sedberry S, Reimer RA. Incidence
of surgical site infection in the foot and ankle with early
exposure and showering of surgical sites: a prospective
observation. J Foot Ankle Surg. 2014;53(2):173-5.
doi:10.1053/j.jfas.2013.12.021
Dayton P, Feilmeier M, Sedberry S. Does postoperative
showering or bathing of a surgical site increase the incidence
of infection? A systematic review of the literature. J Foot
Ankle Surg. 2013;52(5):612-4. doi:10.1053/j.jfas.2013.02.016
Hsieh PY, Chen KY, Chen HY, Sheng WH, Chang CH, Wang
CL, et al. Postoperative Showering for Clean and Cleancontaminated
Wounds: A Prospective, Randomized Controlled
Trial. Ann Surg. 2016;263(5):931-6. doi:10.1097/SLA.
Gok F, Demir Korkmaz F, Emrecan B. The effects of showering
in 48-72 h after coronary artery bypass graft surgery through
median sternotomy on wound infection, pain, comfort, and
satisfaction: randomized controlled trial. Eur J Cardiovasc
Nurs. 2021. doi:10.1093/eurjcn/zvab010
Copeland-Halperin LR, Reategui Via YRML, Levy J, Shank
N, Funderburk CD, Shin JH. Does the timing of postoperative
showering impact infection rates? A systematic review and
meta-analysis. J Plast Reconstr Aesthet Surg. 2020;73(7):1306-
doi:10.1016/j.bjps.2020.02.007
Yu YH, Chao S, Lin YK, Chou YY, Liao HH, Loh EW, et al.
The gap between currently available evidence and awareness
in clinical practice of wound care: It is the time to shower
earlier. Surgery. 2018. doi:10.1016/j.surg.2018.01.013
Katsuyama H, Hamasaki H, Yanai H. Habit of Bathing or
Showering Is Beneficially Associated With Body Weight and
Abdominal Circumference in Patients With Type 2 Diabetes.
J Clin Med Res. 2018;10(9):728-31. doi:10.14740/jocmr3510w
Edmiston CE, Jr., Leaper D. Should preoperative showering
or cleansing with chlorhexidine gluconate (CHG) be part of
the surgical care bundle to prevent surgical site infection? J
Infect Prev. 2017;18(6):311-14. doi:10.1177/1757177417
Yu AL, Alfieri DC, Bartucci KN, Holzmeister AM, Rees HW.
Wound Hygiene Practices After Total Knee Arthroplasty:
Does It Matter? J Arthroplasty. 2016;31(10):2256-9.
doi:10.1016/j.arth.2016.03.040
Jayathilake A, Jayaweera J, Kumbukgolla WW, Herath S.
Influence of early postoperative showering in undressed
surgical wound for better clinical outcome. J Perioper Pract.
;30(6):163-69. doi:10.1177/1750458919868903
Toon CD, Sinha S, Davidson BR, Gurusamy KS. Early versus
delayed post-operative bathing or showering to prevent wound
complications. Cochrane Database Syst Rev. 2015;2015(7):
CD010075. doi:10.1002/ 14651858. CD010075 .pub3
Chang IW. Early versus delayed post-operative bathing or
showering to prevent wound complications: a Cochrane review
summary. Int J Nurs Stud. 2016;61:258-9. doi:10.1016/
j.ijnurstu.2016.04.00814. Decalonne M, Lecorche E, Hau E, Petiteau A, Moreau C,
Milan O, et al. Cause Analysis of an Infection in Facelift
Surgery Due to Mycobacterium chelonae. Front Med
(Lausanne). 2019;6:243. doi:10.3389/fmed.2019.00243
Hopman J, Meijer C, Kenters N, Coolen JPM, Ghamati MR,
Mehtar S, et al. Risk Assessment After a Severe Hospital-
Acquired Infection Associated With Carbapenemase-Producing
Pseudomonas aeruginosa. JAMA Netw Open.
;2(2):e187665. doi:10.1001/jamanetworkopen.2018.7665
Uwamino Y, Nishimura T, Sato Y, Tamizu E, Uno S, Mori
M, et al. Showering is associated with Mycobacterium avium
complex lung disease: An observational study in Japanese
women. J Infect Chemother. 2020;26(3):211-14.
doi:10.1016/j.jiac.2019.09.003
Berrios-Torres SI, Umscheid CA, Bratzler DW, Leas B, Stone
EC, Kelz RR, et al. Centers for Disease Control and Prevention
Guideline for the Prevention of Surgical Site Infection, 2017.
JAMA Surg. 2017;152(8):784-91. doi:10.1001/ jamasurg.
0904
Persichino J, Lee H, Sutjita M, Talavera K, San-Agustin G,
Gnass S. Reducing the Rate of Surgical Site Infections After
Breast Surgery With the Use of Larger Volumes of 4%
Chlorhexidine Gluconate Solution as Preoperative Antiseptic
Showering. Infect Control Hosp Epidemiol. 2017;38(3):373-
doi:10.1017/ice.2016.293
Al Salmi H, Elmahrouk A, Arafat AA, Edrees A, Alshehri M,
Wali G, et al. Implementation of an evidence-based practice
to decrease surgical site infection after coronary artery bypass
grafting. J Int Med Res. 2019;47(8):3491-501. doi:10.1177/
Johnson MP, Kim SJ, Langstraat CL, Jain S, Habermann EB,
Wentink JE, et al. Using Bundled Interventions to Reduce
Surgical Site Infection After Major Gynecologic Cancer
Surgery. Obstet Gynecol. 2016;127(6):1135-44. doi:10.1097/
AOG.0000000000001449.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2021 Salman Habib Abbasi, Abdul Basit, Muhammad Farooq, Fazal Hussain Shah
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
Journal of Bahria University Medical & Dental College is an open access journal and is licensed under CC BY-NC 4.0. which permits unrestricted non commercial use, distribution and reproduction in any medium, provided the original work is properly cited. To view a copy of this license, visit https://creativecommons.org/licenses/by-nc/4.0 
