Surgical wound infection: a comparison between dressed and undressed wounds

Abstract

At the University College Hospital, Ibadan, the conventional method of surgical wound dressing is the use of air-tight and relatively water-tight cotton-gauze-elastoplast dressing. This is usually left in place for seven to ten days unless there is evidence of wound infection, in which case the wound is inspected and redressed using the time-consuming sterile technique, in which a box of sterile instruments may have to be shared amongst about 25 surgical patients. A group of 100 patients was randomly selected and this group divided into two. In the first group, A, the surgical wounds were dressed in the usual manner and dressings left for seven to ten days unless there was any evidence of infection. In the second group, B, the wound was left undressed and "uncared" for 24 to 36 hours after surgery. The comparison of the two groups shows that the time-consuming aseptic method of changing and dressing surgically incised wounds 24 to 36 hours after surgery, does not cut down on the rate of wound infection and is probably unnecessary. This may be due to early formation of fibrin at the wound site which offers a protection against invasion of the wound by bacteria. Typhoid perforation of the terminal ileum gave rise to wound infection in all the cases (100%) in the two groups.