Early postoperative exposure of skin to water safe, may not increase risk of infection or other complications: Study

Many standard patient instructions after surgical wound care include keeping the initial dressings clean and dry and free of contamination, and maintained for 24 to 72 hours to avoid the development of infection and to promote healing of the wound, which is in sharp contrast to the energetic levels required to meet daily activities like bathing, leisure, and optimum levels of functioning. The randomized controlled trial comparatively assessed standard keeping of wounds dry and covered for the period of 48 hours to early post-operative (6 hours) water exposure.

This was a randomized controlled, investigator-blinded, comparative study to assess infection rates and other outcomes. In total, 437 patients were randomized to early water exposure (6 hours post-operatively, n = 218) and standard care (48 hours post-operatively, n = 219). Primary outcome: Culture-proven infection. Other outcomes that were measured: bleeding rate, bruising rate, and scar assessment according to the Patient and Observer Scar Assessment Scale.

The key findings of the study were:

• The incidence of culture-proven infection was comparable between the early water exposure group, (1.8%), and the standard care group, (1.4%); this difference was not significant with (p > 0.99).

• There were no differences between groups in rates of bleeding or bruising.

• The scar results, recorded with the POSAS, did not reveal any significant differences between both groups, thus showing similar cosmetic results.

The study has revealed that allowing surgical wounds to get wet as early as six hours after surgery does not increase the rate of complications or infections. Hence, this increases flexibility in the post-operative care routine for patients, hence helping them to return back to normal activities earlier than thought.

This study was conducted in a single academic center. Generalizability of the results is therefore limited, and further studies are required in different clinical settings for the confirmation of these findings.

Surgical wounds can be safely exposed to water immediately after the operation without increasing the risk of infections or compromising the final cosmetic outcome. Evidence suggesting that post-operative care recommendations should be revised to allow greater patient convenience and comfort.

Reference:

Samaan, C., Kim, Y., Zhou, S., Kirby, J. S., & Cartee, T. V. (2024). Early post-operative water exposure does not increase complications in cutaneous surgeries: A randomized, investigator-blinded, controlled trial. Journal of the American Academy of Dermatology. https://doi.org/10.1016/j.jaad.2024.05.098