Intraoperative incision irrigation with high-volume saline reduces surgical site infection for abdominal infections

Wang, Jin1; Lv, Wen1; Xu, Shihai1; Yang, Chao1; Du, Bo1; Zhong, Yuanbo1; Shi, Fei1; Shan, Aijun1

2022-07-12

10.3389/fsurg.2022.927896

Frontiers in Surgery   Impact Factor & Quartile

2296-875X

Purpose: Surgical site infection (SSI) remains one of the most common postoperative complications for patients with abdominal infections. This study aimed at investigating the effectiveness of high-volume normal saline (NS) irrigation in preventing postoperative SSI for patients with abdominal infections. Methods: In this retrospective before-after clinical study, patients who underwent emergency laparotomy due to abdominal infections between Jan 2015 and Dec 2021 were included consecutively. A cohort of 207 patients with NS irrigation was compared to historical controls. A propensity score matching (PSM) with a 1:1 ratio was performed to reduce potential bias. The primary outcome was the 30-day SSI rate. Results: Irrigation (n = 207) and control (n = 207) matched patients were statistically identical on baseline characteristics, perioperative, and intraoperative parameters. Irrigation patients had lower overall SSI rates (10.6% vs. 26.1%, p < 0.001), mainly due to reduction in superficial (4.3% vs. 17.9%) and deep (1.4% vs. 3.9%) SSIs, rather than space/organ SSIs (4.8% vs. 4.3%). Irrigation patients also had lower rates of incision seroma (4.8% vs. 11.6%, p = 0.012), shorter duration of antibiotics use (5.2 +/- 1.7 d vs. 7.2 +/- 2.0 d, p < 0.001), and unplanned readmission (1.0% vs. 8.7%, p < 0.001). Length of hospital stay showed a declining trend with irrigation intervention, while no significant difference was observed. Moreoever, logistic regression revealed that NS irrigationwas an independent protector against SSI (OR 0.309; 95% CI, 0.207-0.462; p < 0.001). Conclusion: Intraoperative incision irrigation with high-volume NS is associated with a lower rate of SSI for patients with abdominal infections.

Saline irrigation surgical site infection laparotomy abdominal infection high-volume

SCI

English

Others

Shenzhen People's Hospital[SYJCYJ202001]

Surgery

Surgery

WOS:000831811200001

FRONTIERS MEDIA SA

Web of Science

1.Jinan Univ, Shenzhen Peoples Hosp, Clin Med Coll 2, Emergency Dept, Shenzhen, Peoples R China
2.Southern Univ Sci & Technol, Affiliated Hosp 1, Shenzhen, Peoples R China

Wang, Jin,Lv, Wen,Xu, Shihai,et al. Intraoperative incision irrigation with high-volume saline reduces surgical site infection for abdominal infections[J]. Frontiers in Surgery,2022,9.

Wang, Jin.,Lv, Wen.,Xu, Shihai.,Yang, Chao.,Du, Bo.,...&Shan, Aijun.(2022).Intraoperative incision irrigation with high-volume saline reduces surgical site infection for abdominal infections.Frontiers in Surgery,9.

Wang, Jin,et al."Intraoperative incision irrigation with high-volume saline reduces surgical site infection for abdominal infections".Frontiers in Surgery 9(2022).