A Study to Compare Healing in Postoperative Wounds with Occlusive Gauze Dressing and after Omitting the Dressing

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A Study to Compare Healing in Postoperative Wounds with Occlusive Gauze Dressing and after Omitting the Dressing

Journal Title: Journal of Medical Science And clinical Research - Year 2015, Vol 3, Issue 5

Abstract

Introduction: The application of dressings to surgical wounds is a custom as old as recorded history . Many studies in the past have demonstrated the safety of exposure of surgical wounds without any complications. The aim of present study was to investigate and compare the outcome of management of clean abdominal incision wound by open that is without dressing or occlusive gauze dressing from fourth day onwards till stitch removal in obstetrics & Gynecological surgeries. Patient and Methods: This was a case control study wherein total 100 patients who were electively operated for obstetrical and gynaecological indications were and randomly divided into two groups. Group I [case group] consisted of 50 patients in whom dressing was done from 4th day onwords till stitch removal. In groupII [control group] occlusive gauze dressin was done. In all 100 patients preoperatively skin was thoroughly cleaned with savlon, betadine and spirit. At the end of surgery haemostasis was secured and all dead spaces were cautiously obliterated. Injectable antibiotics were given upto 5th postoperative day followed by oral antibiotics for next five days. In all cases after surgery dressing was done with gauze pieces and occlusive tape for 4 days. In control group occlusive dressing continued till stitch removal whereas in study group wound was left open after 4th day and only daily betadine painting with sterile gauze piece was continued. Healing of the incisional wound was compared between the two groups with respect to age, socioeconomic status, parity, builty, nutrition, personal hygiene and preoperative haemoglobin status. Also incidence of postoperative complications, resuturing, duration of hospital stay and types of antibiotics used in the two groups were also studied. Result: It was evident that in group I with open dressing 80% of wounds were healthy and only 20% cases had postoperative wound complications. Whereas in groups II with occlusive gauze dressing only 36% wounds were healthy while 64% had one or the other wound complications. However the correlation was not statistically significant [pvalue=0.319] The incidence of resuturing in group I was zero where as in group II the resuturing was required was required in 12%. The difference in the hospital stay of the two groups was not statistically significant in group with 10-16 days hospital stay {p value=0.0127} but was significant in the group of patients with more than 16 days of stay [p value=0.0038]. Similarly the difference in the use of higher antibiotics was not found to be statistically significant [p value=0.0084] Conclusion: The study concluded that 1) omitting dressing of post operative wounds has better outcome than occlusive dressing in terms of lesser complication rate and less duration of hospital stay. 2) It cost and morbidity to patient. 3) It has advantage of saving surgeons time, hospital cost and manpower.

Authors and Affiliations

Dr. Achala Sahai Sharma

Keywords

EP ID EP211601
DOI -
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