Analysis of outcome in two different dressing techniques of surgical incisions at tertiary care hospital

Abstract

Background: Study is conducted to compare surgical site infections (SSIs) at 30 days in early and delayed dressing removal in primary closure of clean and clean contaminated surgical incisions. Also to compare pain, duration of postoperative hospital stay, and cost of dressing in both groups. Study result may change the technique of dressing and reduce the cost of dressing, pain, and hospital stay for patients after surgery. Materials and Methods: This is a Single center, prospective randomized controlled study including 200 patients divided into two groups at tertiary care hospital. Study included patients aged above 15 years who need surgical intervention with abdominal incision. Study compares results of early and delayed dressing removal in laparotomy surgery with clean and clean contaminated wounds. Results: The study shows no significant difference in outcome in relationship to age of these two Groups A and B (P = 0.94). P value for superficial SSI is 0.76, which is statistically insignificant. P value for deep SSI is 0.71, which is also statistically insignificant. Fisher's exact test for SSI with burst abdomen showed P = 1.0, which is insignificant. By applying t test to data in relationship to pain, we find P < 0.001, which is highly significant. With the use of Chi square test, P value for postoperative hospital stay is 0.03, which is statistically significant. The mean cost of dressing is significantly lower in GroupA than in GroupB (P < 0.0001). Conclusion: SSI is same in both early and delayed dressing removal in primary closure of surgical incisions. There are no significant changes in terms of superficial and deep SSIs and burst abdomen, following early dressing removal. Moreover, the duration of hospital stay is significantly lower in patients with early dressing removal as compared to conventional dressing removal of incision following surgery. Postoperative pain and cost of dressing are also reduced in early dressing removal compared to delayed dressing removal of primary incision closure following surgery. As early dressing removal reduces pain and cost of dressing, it can be applied in routine clean and clean contaminated surgical incisions.