Randomized trial comparing dressing to no dressing of surgical wounds in a tropical setting

OBJECTIVE: to see whether there was a difference in the risk of local infection for surgical wounds in a tropical setting depending on whether a wound was dressed or left open beyond 48 hours post-operatively. METHOD: Over a four month period, 102 patients undergoing intra-abdominal surgery classified as clean or clean-contaminated were randomized into two equal groups. The "with dressing" group underwent a wound dressing change and re-application every two days. In the "without dressing" group, the wound was left open to the air after a first dressing change at 48 hours. RESULTS: There was no difference in post-operative temperature curve; post-operative wound infection rate was 2% in each group. Suture removal was performed two days earlier in the "without dressing" group and hospital stay was decreased by two days. The expense of repeated dressing changes was also lessened. CONCLUSION: There is no benefit to leaving a wound dressing in place longer than 48 hours after surgery; costs related to prolonged hospitalization and expenses of dressing changes are decreased by a policy of leaving incisions undressed after 48 hours.