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Postoperative Showering for Clean and Clean-contaminated Wounds: A Prospective, Randomized Controlled Trial

Pei-Yin Hsieh, Kuen-Yuan Chen, Hsuan-Yu Chen, Wang-Huei Sheng, Chin-Hao Chang, Chiou-Ling Wang, Pin-Yi Chiag, Hsiao-Ping Chen, Chin-Wen Shiao, Po-Chu Lee, Hao-Chih Tai, Hsiung-Fei Chien, Po-Jui Yu, Been-Ren Lin, Yeur-Hur Lai, Jin-Shing Chen, Hong-Shiee Lai
Annals of Surgery 2016, 263 (5): 931-6

OBJECTIVE: To evaluate wound infection rates, pain scores, satisfaction with wound care, and wound care costs starting 48 hours after surgery.

BACKGROUND: Showering after surgery is a controversial issue for wound care providers and patients. We investigated the benefits and detriments of showering for postoperative wound care.

METHODS: Patients undergoing thyroid, lung, inguinal hernia, and face and extremity surgeries with clean or clean-contaminated wounds were included. The patients were randomized to allow showering (shower group) or to keep the wound dry (nonshower group) for postoperative wound care starting 48 hours after surgery. The primary endpoint was the rate of surgical wound infection. The secondary endpoints included the wound pain score, satisfaction with wound care, and cost of wound care.

RESULTS: Between May 2013 and March 2014, there were 222 patients randomized to the shower group and 222 to the nonshower group. Two patients in each group were lost to follow-up. There were 4 superficial surgical site infections in the shower group and 6 in the nonshower group (4/220, 1.8% vs 6/220, 2.7%, P = 0.751). Postoperative pain scores were comparable between the 2 groups. Patients in the shower group were more satisfied with their method of wound care, and their wound care costs were lower when compared with the nonshower group.

CONCLUSIONS: Clean and clean-contaminated wounds can be safely showered 48 hours after surgery. Postoperative showering does not increase the risk of surgical site complications. It may increase patients' satisfaction and lower the cost of wound care.


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