Wound Irrigation Using Wet Gauze May Reduce Surgical Site Infection Following Laparoscopic Appendectomy

Abstract

PurposeThis study aimed to compare the perioperative outcomes of wet gauze and conventional irrigation after laparoscopic appendectomy to determine whether wet gauze irrigation can help reduce surgical site infection (SSI).MethodsA total of 308 patients undergoing laparoscopic appendectomy were included in this study between December 2018 and May 2020. Of these, 132 (42.9%) received gauze irrigation (group 1), and 176 patients (57.1%) received conventional irrigation (group 2). Pre-operative outcomes and complications, including SSI, were compared after propensity score matching (PSM) to adjust for baseline differences and selection bias.ResultsAfter 1:1 PSM, 92 well-matched patients in each group were evaluated. Regarding perioperative outcomes between groups 1 and 2, the rate of severe complications (Clavien-Dindo Classification grades III, IV, and V), operative time, and readmission rate did not differ between the groups. Superficial/deep SSIs were observed more frequently in group 2 (8/92 cases) than in group 1 (1/92 cases; p = 0.017). The organ/space SSIs rate was not significantly different between the two groups (1/92 group 1 and 0/92 group 2, p = 0.316). However, post-operative hospital stay was significantly longer in group 2 (2.8 ± 1.3 days) than in group 1 (1.6 ± 1.2 days; p < 0.001). In the univariate analyses, wound irrigation using wet gauze was an independent protective factor for superficial or deep SSI (p = 0.044).ConclusionsWound irrigation using wet gauze after fascia closure has a significant beneficial effect on reducing post-operative superficial/deep SSI following laparoscopic appendectomy.

Clinical impact of a multimodal pain management protocol for loop ileostomy reversal

“…Moreover, wound irrigation was performed with only wet gauze after fascia closure. It was associated with a reduced incidence of superficial or deep SSI and decreasing the length of hospital stay [21].…”

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

“…The causes of SSI are multifactorial, deriving from the interplay among surgical, environmental, and patient-related factors ( 14 ). Wound contamination of bacteria is considered the most common factor, followed by deposition of tissue debris and blood clots, especially during laparotomy ( 15 ). Thus, theoretically, irrigation flushes out bacteria, blood clots and tissue debris from the incision, which are the most critical factors for developing SSI.…”