Dirty laparotomy wound irrigation for prevention of surgical site infection: a comparison of normal saline vs 1% povidone iodine solution.
Keywords:
Normal saline, povidone iodine, Surgical site infection, dirty woundsAbstract
Background: Surgical site infection (SSI) is a serious complication that limits the expectations and benefit of surgical interventions following laparotomy for secondary peritonitis. It is associated with increased morbidity and mortality. The effectiveness of normal saline compared to povidone iodine in intraoperative wound irrigation during closure of laparotomy wounds for reduction of surgical site infection remains contentious.
Aim and objective: The study aims to evaluate if any, the advantages of irrigating laparotomy wounds of secondary peritonitis with 1% Povidone Iodine solution over Normal Saline in SSI prevention.
Methods: This was a prospective randomized study which was carried out in the department of surgery at Irrua Specialist Teaching Hospital over a 12-month period. Sixty-four (64) patients who were admitted in our department for secondary peritonitis who met the inclusion criteria were randomly assigned into two groups. Group A had the subcutaneous layer irrigated with 250mls of Normal Saline (N-S) while Group B had the subcutaneous layer irrigated with 250mls of 1% Povidone iodine (PVI). Post-operative wound outcomes were measured by comparing the infection rates of the wounds. A p-value ≤0.05 was considered significant.
Results: In all, there were 43 (67.19%) males and 21 (32.81%) females. The mean age in group A was 46.67 ± 2.92 years while group B was 41.21± 2.79 years (p-value 0.18). Surgical site infection was seen in 16 of 64 (25%) participants, 8 in each of the sub-groups (p 1.00).
Conclusion: The SSI rate after laparotomy for secondary peritonitis in this study was 25% each in the Normal Saline and 1% Povidone Iodine arms. There was no significant difference.
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