The Role of Perfumes in Surgical Wound Infections and Wound Healing: A Case-Control Study

A common complication of post-surgical procedures is surgical site infections (SSIs), and wound healing can be gravely affected by these SSIs. Perfumes are known for their use in personal hygiene; however, their role in surgical wound healing and SSIs has not been thoroughly studied. The present study explores the post-operative usage of perfumes in the context of SSIs and wound healing. This was a case-control study conducted in Hail City's Tertiary Care Hospital in Saudi Arabia for 9 months (April-December). The participants were adults undergoing clean elective plastic surgeries. Sixty-three patients were divided into case (n = 31) and control (n = 32) groups; the former used perfumes continuously post-operation and the latter refrained from them. All patients were observed and followed for three follow-up periods. Data on their demography, characteristics of wounds, patterns of perfume use (Arabic, Western and mixed), and infection outcomes were collected and statistically analysed using SPSS v22 at the significance level of < 0.05. In the present study, 49.21% of the total participants kept using perfume after their surgeries. The abdomen was the most common operative site in the control (16, 32%) and case (15, 48.38%) groups. The majority of the patients in the control (15, 46.87%) and case (21, 67.74%) groups had wound size > 15 cm (p > 0.05). Amongst 31 patients in the case group, most of the patients used mixed (Arabic and Western) perfumes (12, 38.7%, p = 0.65). The frequency of perfume application varied, as most participants (11, 35.48%) reported using perfume twice daily (p = 0.49). Meanwhile, 22 (71%) used 2-4 sprays per application (p < 0.05). During the first follow-up, SSIs were only reported amongst patients in a case group (2, 6.45%, p = 0.14). During the second follow-up, SSIs were observed in 3 (9.67%) and 2 (6.25%) patients in the case and control groups, respectively (p = 0.61). Meanwhile, in the third follow-up, the SSI pattern was changed, and patients in the control group developed SSIs (p = 0.10). Furthermore, a non-significant (p > 0.05) association was observed amongst the risk factors, including age, comorbidities, perfume types, operation type, wound site and wound size with infection rates. SSIs are not significantly associated with perfume usage after surgeries, even though the rates were higher amongst the non-perfume users. Future research can explore the biochemical analyses of different perfume types and their psychophysiological effects on wound healing.