Sterile versus clean technique in postoperative wound care of patients with open surgical wounds: a pilot study

This study was completed to determine whether there were differences between sterile versus clean dressing change technique for open surgical wounds in the postoperative period with respect to (1) rate of wound healing and (2) cost of supplies.

A two-group design was used for this pilot study. Of a sample of 30 patients undergoing elective gastrointestinal operations with wounds healing by secondary intention, 15 were men and 15 were women. Mean age was 40.6 years (SD 13.0 years). Patients were randomly assigned to receive clean or sterile dressings, and the intervention was begun on the first postoperative day and repeated three times a day until discharge from the hospital. Analysis of rate of healing was performed with the Mann-Whitney U test: cost analysis was completed with a t test.

Subjects were studied for 3 to 9 days. Groups were homogeneous of the start of treatment with respect to age, length of operation, wound volume, nutritional status, and perfusion. There was no difference in rate of wound healing between the clean and sterile groups. Mean cost was significantly less for the clean group than for the sterile group.

These pilot study data show no difference in rate of wound healing with clean versus sterile technique, and clean technique is less expensive. These findings need to be confirmed with a larger sample; type II error cannot be ruled out.