The Solution to Pollution Is Dilution

In our last FIX, we reported on the surprising result of antibiotic powder not achieving the goal of decreased surgical site infections (SSIs). A more conventional approach is wound irrigants.

But which irrigant?

Reporting on more than 17,000 patients as part of a meta-analysis, Hannah Groenen et al. focused on the 1,300 patients who had SSIs and compared intra-operative incisional wound irrigation with an antiseptic solution, antibiotic solution or saline solution.

And the winner is … antiseptic solution

Using antiseptic solution resulted in the highest level of certainty, while using an antibiotic solution led to low certainty. Both were superior to no irrigation. It is suggested to avoid using antibiotic wound irrigation due to the lower certainty of evidence for its effectiveness and concerns about global antimicrobial resistance.