Abstract

META-ANALYSIS: SAFETY OF PROPHYLACTIC INTRA-OPERATIVE WOUND IRRIGATION FOR PREVENTION OF SURGICAL SITE INFECTIONS

*Lana Khalid Alghabra, Muteb Sulaiman Saif ALSHammari, Rakan Mohammed Alshuwaykan, Amani Dawood Kamil, Abdulelah Tawfiq Fardus, Asma Abdullah Alsowiyan, Faris Abdulhamid Nouh, Dania Ramzi Jei, Albara Ibraheem Faqihi, Rayan Ali Barakat

Abstract

Background & Purpose: Wound irrigation is intended to physically remove cellular debris, surface bacteria, and body fluids, to dilute possible contamination, and to function as a local antibacterial agent when an antiseptic or antibiotic agent is used. Practices vary depending on the patient population, the surface of application, and solutions used. The Aim of this work is to provide cumulative data about the safety of prophylactic intra-operative wound irrigation (pIOWI) using different solutions for prevention of surgical site infections. Methods: A systematic search was performed of PubMed, Cochrane library Ovid, Scopus & Google scholar to identify Surgery RCTs, clinical trials, and comparative studies, which studied the outcome of Intervention group (using povidone–iodine ―PVP‖), versus Control group (using saline irrigation) for surgical wounds. A meta-analysis was done using fixed and random-effect methods. The main outcome of interest was rate of surgical site infections. We also calculated safety (adverse outcomes), for each group through rate of surgical wound infections. Results: A total of 6 studies were identified involving 2428 patients, with 1230 patients in Intervention group, and 1198 patients in Control group. Regarding safety outcome measure, the random-effects model of the meta-analysis study showed significant decrease in surgical site infections in Intervention group compared to Control group (p = 0.038). Conclusion: To conclude, Povidone-iodine irrigation proved to be effective in decreasing postoperative surgical wound infections in different surgeries with no negative influence on the clinical outcome.

Keywords: Prophylactic Intra-Operative Wound Irrigation, Surgical site infections.