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Postoperative Showering for Clean and Clean-contaminated Wounds: A Prospective, Randomized Controlled Trial
Pei-Yin Hsieh1, Kuen-Yuan Chen, Hsuan-Yu Chen
1*Department of Nursing, National Taiwan University College of Medicine, Taipei, Taiwan †Department of Surgery, National Taiwan University College of Medicine, Taipei, Taiwan ‡Institute of Statistical Science, Academia Sinica, National Taiwan University College of Medicine, Taipei, Taiwan §Department of Internal Medicine, National Taiwan University College of Medicine, Taipei, Taiwan ¶Department of Medical Research, National Taiwan University College of Medicine, Taipei, Taiwan ||Department of Traumatology, National Taiwan University College of Medicine, Taipei, Taiwan **School of Nursing, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan.
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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