Simple Wound Irrigation in the Postoperative Treatment for Surgically Drained Spontaneous Soft Tissue Abscesses: A Prospective, Randomized Controlled Trial

• Published in: World journal of surgery 2020-12, Vol.44 (12), p.4041-4051
• Main Authors: Oehme, F., Rühle, A., Börnert, K., Hempel, S., Link, B.-C., Babst, R., Metzger, J., Beeres, F. J.-P.
• Format: Article
• Language: English
• Subjects: Abdominal Surgery; Abscesses; Cardiac Surgery; Clinical trials; General Surgery; Medicine; Medicine & Public Health; Original Scientific Report; Pain; Patients; Postoperative period; Quality of life; Soft tissues; Surgery; Thoracic Surgery; Tissues; Vascular Surgery; Wound healing
• ISSN: 0364-2313; 1432-2323
• DOI: 10.1007/s00268-020-05738-1

Background Soft tissue abscesses are among the most frequently encountered medical problems treated by different surgeons. Standard therapy remains incision and drainage with sterile saline irrigation during postoperative wound healing period. Aim of this prospective randomized controlled trial was to compare sterile irrigation versus nonsterile irrigation. Study design A single center randomized controlled trial was performed to investigate postoperative wound irrigation. The control group used sterile irrigation, and the intervention group used nonsterile irrigation. Primary endpoints were reinfection and reintervention rates, assessed during follow-up controls for up to 2 years. Secondary endpoints were the duration of wound healing, inability to work, pain and quality of life. Results Between 04/2016 and 05/2017, 118 patients were randomized into two groups, with 61 allocated to the control- and 57 to the intervention group. Reinfection occurred in a total of 4 cases (6.6%) in the sterile protocol and 4 (7%) in the nonsterile protocol. Quality of life and pain values were comparable during the wound healing period, and patients treated according to the nonsterile irrigation protocol used significantly fewer wound care service teams. Despite equal wound persistence rates, a substantially shorter amount of time off from work was reported in the nonsterile protocol group ( p value 0.086). Conclusion This prospective, randomized trial indicates that a nonsterile irrigation protocol for patients operated on for soft tissue abscesses is not inferior to the standard sterile protocol. Moreover, a nonsterile irrigation protocol leads to a shorter period of inability to work with comparable pain and quality of life scores during the wound healing period.