The effects of showering in 48–72 h after coronary artery bypass graft surgery through median sternotomy on wound infection, pain, comfort, and satisfaction: randomized controlled trial

Abstract

Aims Time of showering after surgery is still a controversial issue for surgical patients and health professionals. We evaluated the effects of showering in 48–72 h after median sternotomy on sternal wound infections, pain due to sternotomy, patient comfort, and satisfaction levels. Methods and results The study was a randomized controlled clinical trial. Fifty-one patients were randomly allocated (1:1) to the shower (n = 26) or non-shower group (n = 25). The patients in the shower group (intervention group) showered in the first 48–72 h after surgery and the patients in the non-shower group (control group) were not allowed to shower until their chest tube sutures were removed. They were instructed to shower on the next day after removal of the chest tube sutures. The rate of sternal wound infections was significantly lower in the shower group (n = 2, 7.7%) than in the non-shower group patients (n = 8, 32.0%; P = 0.038). A logistic regression analysis showed that early post-operative showering was protective and significantly reduced the risk of sternal wound infections independently of other variables [odds ratio (OR): 0.177; 95% confidence interval (CI): 0.033–0.940; P = 0.042]. The pain severity score was significantly lower in the shower group patients. Also, comfort and satisfaction scores were significantly higher in this group (P < 0.05). Conclusion Early showering after sternotomy was found to be protective against sternal wound infections and had a positive effect on pain, comfort, and satisfaction. Trial registration Clinical Trials.gov registration number NCT04250961 (https://clinicaltrials.gov/ct2/show/NCT04250961).

Postoperative Showering for Patients With Closed Suction Drainage: A Retrospective Cohort Study of Deep Inferior Epigastric Perforator Flap Breast Reconstructions

“…In the report by Hsieh et al, patients started postoperative showering after CSD removal [ 10 ], although the reason for this was not stated. Gök et al noted that the sternal incision site was never exposed to water after coronary artery bypass graft surgery until the removal of the chest tube sutures according to their institution’s standards [ 13 ]. This suggests that their patients were not allowed to shower while the chest tube was connected to the patient’s body.…”

“…Moreover, Gök et al stated that early postoperative showering after sternotomy for coronary artery bypass graft surgery was protective against sternal wound infections [ 13 ]. They have also stated that the patients who took a shower within 48-72 hours postoperatively had significantly lower pain scores and higher comfort and satisfaction scores than the patients who did not take a shower in the early postoperative period [ 13 ]. Hsieh et al have revealed that postoperative wounds can be safely showered 48 hours after surgery [ 10 ].…”

Comparison of Early Versus Delayed Showering on Post-Operative Wound Infections

“…After surgery the optimization of lung functions and oxygen carrying capacity of blood is helpful in combating the various pathogens responsible for contagious complications. 5 Even though these recommendations are circulated in almost all healthcare centers but evaluation regarding compliance is somewhat not up to the mark. The breaches in the infection control procedures can lead to significant increase in SSIs.…”

“…Some studies showed the decrease in wound pain after early showering and reduction in SSIs. 5,9 A recent literature review showed that early showering does not cause the increase in frequency of SSIs or other wound complications. 6 In our study, we focused on whether the frequency of SSIs in influenced by early showering after clean and cleancontaminated surgeries.…”

“…7.7% versus 32% (p value 0.038). 5 Various systemic reviews showed that early or late showering does not influence frequency of SSIs after clean and clean contaminated surgeries. 3,6,7,12,13 All reviews concluded that…”