sodium-hypochlorite and Abscess

Surgical site infections (SSIs) are wound infections that occur after an operative procedure. A preventable complication, they are costly and associated with poorer patient outcomes, increased mortality, morbidity and reoperation rates. Surgical wound irrigation is an intraoperative technique, which may reduce the rate of SSIs through removal of dead or damaged tissue, metabolic waste, and wound exudate. Irrigation can be undertaken prior to wound closure or postoperatively. Intracavity lavage is a similar technique used in operations that expose a bodily cavity; such as procedures on the abdominal cavity and during joint replacement surgery.. To assess the effects of wound irrigation and intracavity lavage on the prevention of surgical site infection (SSI).. In February 2017 we searched the Cochrane Wounds Specialised Register; the Cochrane Central Register of Controlled Trials (CENTRAL); Ovid MEDLINE; Ovid Embase and EBSCO CINAHL Plus. We also searched three clinical trials registries and references of included studies and relevant systematic reviews. There were no restrictions on language, date of publication or study setting.. We included all randomised controlled trials (RCTs) of participants undergoing surgical procedures in which the use of a particular type of intraoperative washout (irrigation or lavage) was the only systematic difference between groups, and in which wounds underwent primary closure. The primary outcomes were SSI and wound dehiscence. Secondary outcomes were mortality, use of systemic antibiotics, antibiotic resistance, adverse events, re-intervention, length of hospital stay, and readmissions.. Two review authors independently assessed studies for inclusion at each stage. Two review authors also undertook data extraction, assessment of risk of bias and GRADE assessment. We calculated risk ratios or differences in means with 95% confidence intervals where possible.. We included 59 RCTs with 14,738 participants. Studies assessed comparisons between irrigation and no irrigation, between antibacterial and non-antibacterial irrigation, between different antibiotics, different antiseptics or different non-antibacterial agents, or between different methods of irrigation delivery. No studies compared antiseptic with antibiotic irrigation. Surgical site infectionIrrigation compared with no irrigation (20 studies; 7192 participants): there is no clear difference in risk of SSI between irrigation and no irrigation (RR 0.87, 95% CI 0.68 to 1.11; I. The evidence base for intracavity lavage and wound irrigation is generally of low certainty. Therefore where we identified a possible difference in the incidence of SSI (in comparisons of antibacterial and non-antibacterial interventions, and pulsatile versus standard methods) these should be considered in the context of uncertainty, particularly given the possibility of publication bias for the comparison of antibacterial and non-antibacterial interventions. Clinicians should also consider whether the evidence is relevant to the surgical populations under consideration, the varying reporting of other prophylactic antibiotics, and concerns about antibiotic resistance.We did not identify any trials that compared an antibiotic with an antiseptic. This gap in the direct evidence base may merit further investigation, potentially using network meta-analysis; to inform the direction of new primary research. Any new trial should be adequately powered to detect a difference in SSIs in eligible participants, should use robust research methodology to reduce the risks of bias and internationally recognised criteria for diagnosis of SSI, and should have adequate duration and follow-up.

Topics: Abscess; Anti-Bacterial Agents; Anti-Infective Agents, Local; Drug Combinations; Humans; Hypochlorous Acid; Incidence; Povidone-Iodine; Randomized Controlled Trials as Topic; Sodium Hypochlorite; Surgical Wound Dehiscence; Surgical Wound Infection; Therapeutic Irrigation

To clinically compare the healing of abscess wounds dressed with either crude undiluted honey or Edinburgh University solution of lime (EUSOL).. A prospective clinical randomized study.. The Isolation Children's Ward of the Wesley Guild Hospital, Ilesa, an affiliate of the Obafemi Awolowo University, Ile-Ife, Nigeria.. Thirty-two (32) Nigerian children with 43 pyomyositis abcesses.. All subjects had fresh surgical incision and drainage of the abcesses and a 21-day course of ampicillin plus cloxacillin (Ampiclox) and gentamicin; the wounds were left to close spontaneously with twice-daily wound dressing with packing of the abscess cavity with either honey- or EUSOL-soaked gauze in two randomized treatment groups.. The clinical conditions of the wound sites were documented on days 1, 3, 7, and 21 as either clean or dirty, dry or wet, granulation tissue present or absent, and epithelialization present or absent; the length of hospital stay was also measured.. Honey-treated wounds demonstrated quicker healing and the length of hospital stay was significantly shorter in patients with honey-treated wounds than those treated with EUSOL (t = 2.45, p = 0.019).. Honey is a superior wound dressing agent to EUSOL. Honey is recommended for the dressing of infected wounds, more so in tropical countries, where it is most readily available.

Topics: Abscess; Administration, Cutaneous; Adolescent; Anti-Infective Agents, Local; Bandages; Borates; Child; Child, Preschool; Female; Honey; Humans; Infant; Length of Stay; Male; Nigeria; Prospective Studies; Sodium Hypochlorite; Time Factors; Treatment Outcome; Wound Healing

Seventy-five consecutive patients with pilonidal sinus disease were randomized to receive either Eusol dressings or Silastic foam dressings. Patients were divided into those with pilonidal sinus and pilonidal abscess. There was no significant difference between time to hospital discharge or time to full healing in either group. The cost benefits and simplicity of Silastic foam dressing are discussed.

Topics: Abscess; Adolescent; Adult; Anti-Infective Agents; Borates; Female; Hospitalization; Humans; Length of Stay; Male; Occlusive Dressings; Pilonidal Sinus; Postoperative Care; Silicone Elastomers; Sodium Hypochlorite; Wound Healing

Whether decolonization following incision and drainage (I&D) for methicillin-resistant Staphylococcus aureus (MRSA) abscess decreases repeat I&D and MRSA-positive cultures in children is unknown.. Referral to the Pediatric Infectious Disease Service (PIDS) for decolonization was determined for eligible children (2003-2010), with outcomes studied over 12 months.. We identified 653 children; 54 had been seen by PIDS. In the PIDS group, no patients (0/54, 0%) had a repeat I&D. In the no PIDS group 36/599 (6%) had a repeat I&D, P = .06. Logistic regression modeling for repeat I&D showed no significant effect, odds ratio = 0.29; 95% confidence interval = 0.04-2.15; P = .23. In the PIDS group, 3 patients (3/54, 5.6%) had a repeat MRSA-positive culture. In the no PIDS group, 58/599 (9.7%) had a positive repeat culture, P = .46. Logistic regression modeling for positive culture showed no significant effect (odds ratio = 0.55; 95% confidence interval = 0.17-1.81; P = .32).. We detected no statistically significant association between decolonization and repeat I&D or MRSA-positive culture.

Topics: Abscess; Administration, Intranasal; Anti-Bacterial Agents; Baths; Child; Child, Preschool; Cohort Studies; Disinfectants; Drainage; Female; Humans; Longitudinal Studies; Male; Methicillin-Resistant Staphylococcus aureus; Mupirocin; Retrospective Studies; Risk Factors; Sodium Hypochlorite; Staphylococcal Infections; Treatment Outcome

Topics: Abscess; Adolescent; Adult; Aged; Anti-Infective Agents; Female; Humans; Male; Sodium Hypochlorite; Treatment Outcome; Wound Infection

Topics: Abscess; Adult; Humans; Male; Middle Aged; Peritoneal Lavage; Retroperitoneal Space; Sodium Hypochlorite; Therapeutic Irrigation