Introduction. The incidence of surgical site infections (SSIs) is reducing following the global campaign that requires all the stakeholder involvement. However, of all hospital-acquired infection prevention programs, wound irrigation is hard to be implemented in our hospital. There is a belief that the wound irrigation procedure leading to the spreading of infection. In contrast, the use of antiseptic and topical antibiotic, as well as systemic antibiotic, is uncontrolled high. Thus, we run a cost-effective study of wound irrigation to change the practice. Method. We carried out a prospective cohort study comparing wound irrigation and the standard protocol in wound care in those underwent median laparotomy during the period of January to July 2018. A total of 80 subjects enrolled in this study, which divided into two groups, 40 for each group. The first group was those treated using antiseptics (povidone-iodine) and antibiotic contained paraffin tulle, while the second group was those treated using irrigation. This study performed in the digestive surgery division, which initiated irrigation protocol for wound irrigation. Stitch specimen taken for bacterial culture proceeded on 7 th day postoperative and clinical signs of infection following CDC criteria was observed then statistically analyzed. Results. The bacterial culture showed no significant difference (p = 0.82) between the two groups. Clinical signs are showing no significant difference between the two groups (p = 1.00). In the cost perspective, the application of wound irrigation saving IDR 57,500,00 or four USD per subject. Conclusion: Wound irrigation using distilled water efficiently prevent SSIs.

Introduction.Skin cancer is one of many kinds of cancer which incidence increases globally. Basal cell carcinoma (BSC) and squamous cell carcinoma (SCC) are the most common prevalence of non-melanoma skin cancer, and also are the most common cancer among skin cancer. The main therapy for such skin cancer is wide excision within its safety margin added by adjuvant therapy. Despite adequate therapy, people with skin cancer still have a risk of recurrence. This study assesses the prognostic factors of recurrence among people with non-melanoma skin cancer who underwent wide excision surgery. Method. This study was a retrospective cohort with survival analysis. The patient's data who underwent wide excision surgery were from Perhimpunan Ahli Bedah Onkologi Indonesia (PERABOI) registry and medical record from Oncology Surgery Division in RSCM from January 2012-December 2015. Data selection was done based on inclusion and exclusion criteria. Results. There were 187 patients with non-melanoma skin cancer who underwent wide excision surgery; the recurrence was detected on 15% of the case. Most of the patients were ≥45 years old with the most common histopathological feature of the skin cancer was basal cell carcinoma. We did a survival analysis with Cox regression and the result was previous history of skin cancer (RR 6.903; 95% CI 2.925-16.292), perineural invasion (HR 3.818; 95% CI 1.561-9.340), location of the lesion (HR 0.071; 95% CI 0.022-0.228), and size of the tumor (HR 1.842; 95% CI 1.244-2.729) was the factors that increased recurrence. Conclusion. History of previous skin cancer, perineural invasion, location of the lesion, and size of the tumor were the prognostic factors for recurrence among patients with non-melanoma skin cancer who underwent wide excision surgery.