# Wound Irrigation in the Prevention of Surgical Site Infection in Elective Colorectal Surgery: A Retrospective Cohort Study

## TL;DR

This study examines whether wound irrigation with pulse lavage reduces surgical site infections in elective colorectal surgery.

## Contribution

The study provides empirical evidence on the use of pulse lavage in elective colorectal surgery for infection prevention.

## Key findings

- Pulse lavage group had a 14.47% infection rate versus 19.18% in the standard closure group.
- The difference in infection rates was not statistically significant (p = 0.213).
- The study suggests the need for randomized controlled trials to confirm potential benefits of pulse lavage.

## Abstract

Background

Surgical site infection in colon surgery is associated with significant cost and increased length of hospital stay. Recently, there has been interest in the use of pulsed lavage to reduce the risk of surgical site infection in contaminated wounds. Although increasingly used and gaining popularity, its effectiveness in elective colorectal surgery has been poorly documented. This study aimed to investigate the incidence of surgical site infection within 30 days of elective colorectal surgery in patients who underwent wound irrigation with pulse lavage versus standard closure.

Methodology

A retrospective study was conducted at a university hospital over a two-year period between January 2020 and December 2021. All adult patients who underwent elective colorectal surgery were eligible for inclusion.

Results

A total of 222 patients underwent elective colorectal surgery during the study period. Operative procedures included abdominoperineal resections, left and right hemicolectomies, pelvic exenterations, small bowel or large bowel resections, as well as stoma reversals, formations, and refashioning. In total, 76 patients underwent pulse lavage while 146 did not. The total number of surgical site infections was 39 during the study period. Infection rates in the pulse lavage group were 14.47% compared to 19.18% in the standard closure group. The chi-square analysis concluded the difference in infection rates was not statistically significant (p = 0.213).

Conclusions

The findings demonstrated a difference in infection rates of almost 5% favouring the pulse lavage group; however, it did not reach a statistical difference. Although infection rates were in keeping with those described in the literature, further studies in the form of randomized controlled trials should be performed to determine the benefits, if any, of pulse lavage in colorectal surgery.