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. 2022 Jul 12:9:927896.
doi: 10.3389/fsurg.2022.927896. eCollection 2022.

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

Jin Wang  1 , Wen Lv  1 , Shihai Xu  1 , Chao Yang  1 , Bo Du  1 , Yuanbo Zhong  1 , Fei Shi  1 , Aijun Shan  1
Affiliations

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

Jin Wang et al. Front Surg. .

Abstract

Purpose: Surgical site infection (SSI) remains one of the most common postoperative complications for patients with abdominal infections. This study aimed at investigating the effectiveness of high-volume normal saline (NS) irrigation in preventing postoperative SSI for patients with abdominal infections.

Methods: In this retrospective before-after clinical study, patients who underwent emergency laparotomy due to abdominal infections between Jan 2015 and Dec 2021 were included consecutively. A cohort of 207 patients with NS irrigation was compared to historical controls. A propensity score matching (PSM) with a 1:1 ratio was performed to reduce potential bias. The primary outcome was the 30-day SSI rate.

Results: Irrigation (n = 207) and control (n = 207) matched patients were statistically identical on baseline characteristics, perioperative, and intraoperative parameters. Irrigation patients had lower overall SSI rates (10.6% vs. 26.1%, p < 0.001), mainly due to reduction in superficial (4.3% vs. 17.9%) and deep (1.4% vs. 3.9%) SSIs, rather than space/organ SSIs (4.8% vs. 4.3%). Irrigation patients also had lower rates of incision seroma (4.8% vs. 11.6%, p = 0.012), shorter duration of antibiotics use (5.2 ± 1.7 d vs. 7.2 ± 2.0 d, p < 0.001), and unplanned readmission (1.0% vs. 8.7%, p < 0.001). Length of hospital stay showed a declining trend with irrigation intervention, while no significant difference was observed. Moreoever, logistic regression revealed that NS irrigationwas an independent protector against SSI (OR 0.309; 95% CI, 0.207-0.462; p < 0.001).

Conclusion: Intraoperative incision irrigation with high-volume NS is associated with a lower rate of SSI for patients with abdominal infections.

Keywords: Saline irrigation; abdominal infection; high-volume; laparotomy; surgical site infection.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Flowchart of the study.
Figure 2
Figure 2
Subgroup analysis for surgical site infection in the irrigation group as compared with the control group, assessed by logistic regression analysis with adjustment for the stratification variables.
See this image and copyright information in PMC

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