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 Even though showering can lift patients’ spirits, potentially
speeding recovery, concerns about contamination often prompt doctors
to advise against getting wounds wet until stitches are removed,
which can take many days, or even weeks.
But when researchers randomly permitted some patients with
relatively low-risk surgical wounds to shower 48 hours after their
operations, the people who got to bathe were happier with their care
- and their odds of infection were no different from those of their
unwashed peers.
The findings, along with results from other recent research, should
help convince more doctors to let patients shower after surgery,
said Dr. Paul Dayton, a researcher at Des Moines University and
UnityPoint Health in Iowa who wasn’t involved in the study.
“Traditions are sometimes long to fade away due to lack of good
evidence to support change – this paper will certainly help to drive
change,” Dayton said by email. “Early water exposure may in fact be
a universally safe recommendation.”
For the current study, Dr. Jin-Shing Chen of National Taiwan
University Hospital and colleagues focused on patients with
relatively low-risk wounds, excluding people with infections,
inflammation or injuries caused by outside objects like bullet or
knives entering the body.
The experiment included patients with “clean” wounds, the
lowest-risk category, with no signs of infection after less invasive
operations, and individuals with so-called “clean-contaminated”
wounds, which are uninfected but involve more complex operations
such as chest, ear or gynecologic procedures.
The researchers enrolled 444 patients having surgeries on the
thyroid, lung, face, extremities and certain abdominal hernias. Half
the participants could shower 48 hours after the operations, while
the rest of them had to wait.
Within two weeks of surgery, four patients in the shower group and
six in the unwashed group developed superficial surgical site
infections with redness and swelling, a difference that was too
small to rule out the possibility that it was due to chance.
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All of the patients reported similar levels of pain after surgery,
but the ones who got to shower were more satisfied with their care.
One shortcoming of the study is that doctors knew which patients got
to shower and which didn’t, which has the potential to influence
outcomes, the authors note in the Annals of Surgery. Researchers
also lacked data on the longer-term infection risk since they only
followed patients for two weeks.
It’s also important to note that patients who showered didn’t use
soap or cleanser at the surgical site or submerge the wound, noted
Dr. Heather Evans, an infectious disease and surgery researcher at
the University of Washington and Harborview Medical Center in
Seattle.
All wounds in the study were also relatively small and probably
weren’t under tension that might lead to conditions that can trigger
infections, Evans, who wasn’t involved in the study, added by email.
“I think the take-home message for patients from this particular
study is that showering with water within 48 hours after elective
surgery is safe if the surgical wound is small, had minimal
contamination, and was primarily closed with (stitches),” Evans
said.
SOURCE: http://bit.ly/1NXvvRH Annals of Surgery, online December 10,
2015.
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