Plastic wound protector reduces infections better than gauze in open GI surgery

In patients undergoing open gastrointestinal (GI) surgery, the use of a plastic wound protector results in lower rates of surgical site infections (SSIs) compared with the use of a conventional surgical gauze, according to a study.

A total of 457 patients (mean age 58.4 years, 56.0 percent male, 74.6 percent with a clean-contaminated wound) undergoing open abdominal bowel surgery (eg, for bowel perforation) were randomly assigned to receive a dual-ring, plastic wound protector to protect the incision site of the abdominal wall (experimental group, n=229) or a conventional surgical gauze (control group, n=228).

Within 30 days of open GI surgery, SSIs occurred in a total of 72 patients (15.7 percent). The SSI rate was significantly lower in the group that received wound protector than in the group that received surgical gauze (10.9 percent vs 20.5 percent).

The use of a plastic wound protector versus surgical gauze reduced the likelihood of getting SSIs by 46.81 percent (relative risk reduction [RRR], 46.81 percent, 95 percent confidence interval [CI], 16.64–66.06). A significant reduction was observed for clean-contaminated wounds (RRR, 43.75 percent, 95 percent CI, 3.75–67.13), especially for superficial SSIs (RRR, 42.50 percent, 95 percent CI, 7.16–64.39).

There was no significant between-group difference in the length of hospital stay (mean 15.2 vs 15.3 days) and in the overall postoperative complication rates (20.1 percent vs 18.8 percent).

The findings support the World Health Organization recommendation for use of wound protector devices in abdominal surgery.