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Influence of Intraoperative Iodine Solution Lavage Followed by "Wound Scrubbing" Technique on SSI Frequency

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Wojciechowicz T., Dobosz M., Folwarski M.
Polish Journal of Surgery
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2010
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vol. 82
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issue 8
464-468
EN
The aim of the study was to assess whether intraoperative use of the "wound scrubbing" technique (iodine solution lavage followed by intensive scrubbing of the wound with a surgical drape) reduces the number of surgical site infection (SSI) incidents, considering patients after colorectal surgery.Material and methods. The study group comprised 98 patients qualified towards colorectal surgery during the period between November, 2007 and November, 2008. Patients were divided into two groups: Fifty patients were subject to the "wound scrubbing" technique (group I), while 48 patients constituted the control group (group II) where the wound was treated traditionally-subcutaneous tissue hemostasis was assured, least traumatically. In case of both groups subcutaneous tissue swabs were collected before wound suturing. Primary cutaneous sutures were applied in all patients. The diagnosis of a surgical site infection was based on the criteria established by the National Nosocomial Infectious Surveillance (NNIS) group.Results. According to the NNIS criteria, superficial SSI was diagnosed in 12 patients (12.3%): 4 from the "wound scrubbing" group (8%) and 8 from the control group (16.7%). Deep tissue infections were not observed. Gram-negative bacteria were most often isolated, both in case of group II patients, and SSI cases. Considering the "wound scrubbing" group 66% of intraoperative swabs proved to be sterile.Conclusions. 1. The "wound scrubbing" technique reduces the risk of SSI in case of patients subject to colorectal surgery. 2. Microbial contamination of the postoperative wound (groups II-IV, according to the NNIS) before the introduction of cutaneous sutures directly influences the frequency of surgical site infections.
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