Results of an Early Showering Protocol After Orthopaedic Trauma Surgery

To evaluate the clinical outcomes of a standardized postoperative protocol permitting removal of postoperative dressings, showering, and cleansing of incisional wounds 3 days after fracture surgery.

Retrospective review.

Tertiary orthopaedic center.

All adult patients, aged 18 years or older, operatively treated for fracture or other musculoskeletal trauma from September 2017 to September 2023 were screened for study eligibility. Patients with open fractures, revision surgery through surgical incisions created <6 weeks before the index procedure, immobilization (eg, splints) precluding surgical wound access, known prior infection, acute traumatic local skin abrasions or lacerations, were excluded because these patients were not treated with the early showering protocol. Also excluded were patients with <3-month follow-up.

Outcome measures were reoperation within 3 months for wound or infectious complications and superficial surgical site infection treated with oral antibiotics.

A total of 1067 surgical cases were performed during the included time frame. Six hundred and two cases were excluded based on eligibility criteria, leaving 465 surgeries in 444 patients with a mean age of 59 years (range 18-95; 65% female). Mean follow-up was 11.7 months (SD 12.3; range 3.0-73.0). Reoperation for a wound or infectious complication occurred in 1.1% (5/465) of patients and superficial surgical site infection requiring antibiotic treatment occurred in an additional 1.1% of patients (5/465).

A protocol of dressing removal and showering at 3 days postoperatively for acute uncomplicated surgical wounds was associated with reoperation for deep infection in 1.1% of patients and superficial infection in 1.1% of patients supporting the safety of an early showering protocol.

Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.