In a recent systematic review and meta-analysis published following the PRISMA 2020 guidelines, researchers evaluated the effectiveness of antiseptics versus saline wound irrigation in preventing surgical site infections (SSIs) after laparotomy.
The review included 18 studies with a total of 6,368 patients and analysed data from randomised trials and observational studies published after 1999.
The overall SSI rate was 14.7%. When comparing antiseptic irrigation to saline, the findings showed no statistically significant reduction in SSIs , with very low certainty of evidence.
However, after excluding laparoscopic cases and studies with high risk of bias, antiseptic irrigation demonstrated a favourable effect in reducing infections with moderate certainty.
Additionally, the analysis revealed that any wound irrigation – whether antiseptic or saline – was associated with a significant decrease in SSI rates compared to no irrigation, with moderate certainty.
The authors conclude that wound irrigation, regardless of the solution used, likely lowers SSI rates after laparotomy.
While the evidence regarding antiseptic versus saline irrigation remains uncertain, especially when high-bias studies are excluded, the potential benefits warrant further investigation.
Surgeons should consider these findings when determining intraoperative wound management.
High-quality, standardised trials are recommended to establish definitive practice guidelines.
