OUTCOME OF SALINE WOUND LAVAGE PRIOR TO WOUND CLOSURE IN GYNAECOLOGICAL AND OBSTETRICAL PATIENTS

Objective: To determine the effectiveness of saline wound lavage in reducing wound infections in patients undergoing gynaecological and obstetrical abdominal surgical procedures. Study Design: Quasi-experimental study. Place and Duration of Study: Department of Obstetrics and Gynaecology, Pakistan Navy Ship Shifa Hospital, Karachi Pakistan, from Oct 2018 to Sep 2019. Methodology: All the patients undergoing gynaecological or obstetrical surgical procedures were enrolled after informed consent. Participants underwent elective or emergency surgery. In Group A with 551 patients, saline wound Lavage was done before closure, whereas in 533 patients in group B saline wound irrigation was not done. Similar post-operative care was provided to both groups. All patients were observed for febrile illness and wound discharge on 2nd, 8th, 15th and 30th postoperative day. Results: Out of 1084 patients, there were 551 (50.7%) in saline wound irrigation group A, while 533 (49.3%) were in group B where no saline wound irrigation was done. The frequency of febrile illness was observed in 49 (3.8%) patients. Febrile illness was significantly higher in patients without saline wound irrigation as compared to patients with saline wound irrigation (pvalue 0.002). The frequency of wound discharge was observed in 28 (22.2%) patients. Wound discharge was significantly higher in patients without saline wound irrigation as compared to patients with saline wound irrigation (p-value=0.018). Conclusion: Saline wound irrigation prior to wound closure in obstetrical and gynaecological abdominal procedures can lead to a significant reduction in surgical site infection.