Bath After an Operation Advised To Reduce Risk for Infection on Operative Site and Use of Regular Bar Soaps

Taking a full-body bath and making a focused washing of the operative site reduce the risk of infection on the operative site.  Thus, it is advised for patients to do this after an operation.

The full-body bath and  focused washing of the operative site are to be done starting 24 hours after the operation or earlier.

A bar soap that is being used for daily bath at home by the patient is sufficient.  There is no need to use special soaps such as those containing povidone-iodine and chlorhexidine gluconate.  (Studies have shown that bathing using the special soaps does not significantly reduce incidence of infection at the operative site when compared to bath using regular bar soaps.)


Wounds can be wet

by Reynaldo O Joson on Friday, September 30, 2011 at 7:54am

Can you wet wounds incurred after an operation and after an injury outside an operation setting, say accidental cut on the leg?

ROJOSON’s Inputs:

You can wet wounds, both postoperative and non-postoperative ones, with tap water, particularly when taking a bath. The chances or risk of infection of the wound are NOT increased because of the wetting.  If a wound gets infected, it is due to causes other than wetting such as the wound being heavily contaminated and dirty to start with and a physician closing by suturing a dirty wound rather than leaving it open.

Thus, when taking a bath, do NOT be afraid of having your wound wet.  You don’t have to wrap your wound with plastic materials in an attempt to prevent it from getting wet while taking a bath.  In fact, while taking a bath, you have to gently wash or clean the wound with soap and water.  Doing so will in fact DECREASE the chances of wound infection. 

As a physician and a surgeon, I have been giving this piece of advice during the past 30 years (from 1981 to 2011).  I have been encountering a lot of resistance in my patients when I give this piece of advice because of the prevailing myth in the community, which most likely originated and is being propagated by my physician colleagues and health care professionals up to now.

I am glad that recently I came across at least two research studies that will support my advocacy to change this myth.

Here they are, the conclusions and the references of two research studies:

Conclusion:

“Wetting surgical wounds with clean tap water does not increase, and may even reduce, wound infection rate.”

Reference:

Ulceration and antihypertensive use are risk factors for infection after skin lesion excision.

Penington A.

ANZ J Surg. 2010 Sep;80(9):642-5. doi: 10.1111/j.1445-2197.2010.05344.x.

http://www.ncbi.nlm.nih.gov/pubmed/20840409

Conclusion:

“…wounds can be uncovered and allowed to get wet in the first 48 hours after minor skin excision without increasing the incidence of infection.”

Reference:

Can sutures get wet? Prospective randomised controlled trial of wound management in general practice

Heal C. et al

BMJ 332 : 1053 doi: 10.1136/bmj.38800.628704.AE (Published 24 April 2006)

http://www.bmj.com/content/332/7549/1053.full

ROJOSON’s Recommendations:

You CAN wet wounds, both postoperative and non-postoperative ones, with TAP WATER, particularly when taking a bath.

Don’t be afraid to take a bath after an operation and after you accidentally incur a surface wound in any part of your body.

Don’t be afraid if your body surface wounds get wet while taking a bath.  You don’t need to wrap your wounds with a towel or a plastic in an attempt to prevent them from getting wet.  It is NOT necessary.  It is an UNNECESSARY INCONVENIENCE on your part and on your relatives. ENJOY YOUR BATH.  It contributes to the restoration of your physical and mental well-being after getting a surface wound.

While taking a bath, wash your wound with soap and water. Doing so will in fact decrease the chances of wound infection.



Here is another recent (2013) article to support the stand that postoperative wounds can be wet while taking a bath without increasing the risk of infection.

https://www.unitypoint.org/filesimages/Does%20Postoperative%20Showering%20Increase%20Infection%20A%20Systematic%20Review%20of%20the%20Literature%20A

Does Postoperative Showering or Bathing of a Surgical Site Increase the Incidence of Infection? A Systematic Review of the Literature

Paul Dayton, DPM, MS, FACFAS 1 , Mindi Feilmeier, DPM, FACFAS 2 , Shelly Sedberry, MS 3 1Director, Podiatric Medicine and Surgery Residency, Trinity Regional Medical Center; and Adjunct Professor, Des Moines University, College of Podiatric Medicine and Surgery, Fort Dodge, IA 2 Assistant Professor, Des Moines University College of Podiatric Medicine and Surgery, Des Moines, IA 3 Podiatric Medical Student, Des Moines University College of Podiatric Medicine and Surgery, Des Moines, IA

Conclusion: No increased incidence of infection was found in the patients allowed to shower or bathe as a part of their normal daily hygiene before suture removal compared with those who were instructed to keep the site dry until suture removal.
2013 by the American College of Foot and Ankle Surgeons.

The purpose of the present review was to evaluate the basis for the recommendation to keep sutured surgical incisions dry during the course of healing. The 9 studies in our review included 5 prospective randomized trials, 1 of which was a multicenter trial, 1 prospective cohort of 100 patients with a historical control group, and 3 prospective case series without a control group. These 9 studies revealed that showering or bathing an incision had no bearing on the rate of infection (3,5–12). The evidence reviewed suggests that early bathing or showering of surgical wound incisions does not pose a risk of infection. Patients can return to their normal bathing or showering routine as soon as 12 hours after surgery and, perhaps even earlier, without the fear of increasing their risk of infection. We found no data discussing evidenced-based reasons for keeping a wound dry and covered until suture removal

ROJ@15mar10

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