Comparison Of Intraoperative Wound Irrigation With Aqueous Povidone-Iodine Solution To Normal Saline In Preventing Surgical Site Infections.

BACKGROUND: A surgical site infection (SSI) is a wound infection caused by pathogens, particularly bacteria, that occurs within 30 days of the surgery. Various methods have been employed to minimise infection rates of infection one of which is intra-operative wound irrigation. This study aims to compare the frequency of surgical site infections after wound irrigation of contaminated and dirty wounds with normal saline and aqueous povidone-iodine solutions. METHODS: This randomized controlled trial was carried out in the surgical department of Federal Government Polyclinic Hospital from January to December 2022. A total of 180 patients were randomly divided into two equal groups using blocked randomization. Group A had normal saline irrigation while Group B had aqueous povidone-iodine irrigation before surgical incision closure. Patients were followed till 30th post-operative day. Data was collected, entered and analyzed using SPSS 20.0. RESULTS: A total of 180 patients were recruited in this study, equally divided into Group A and Group B with 90 patients each. Fifty-three patients (58.9%) from group-A and 58 patients (64.4%) from group-B were having contaminated wounds and 37 patients (41.1%) and 32 patients (35.6%) had dirty wounds respectively. Surgical site infection was found in 29 patients (32.2%) of group-A and 26 patients (28.8%) of group-B (p=0.627). there was no significant difference between the two groups concerning surgical site infection. CONCLUSIONS: Irrigation of surgical wounds with aqueous povidone-iodine solution before primary closure was statistically similar to normal saline in preventing surgical site infections in contaminated and dirty wounds.

Early Postoperative Outcomes of Breast Cancer Surgery in a Developing Country.

Background Breast cancer remains the most common cause of cancer related mortality amongst women in Pakistan. Postoperative complications can demoralize the patients and potentially delay adjuvant treatment, leading to adverse outcomes. The overarching aim of the study is to delineate the early postoperative outcomes of breast cancer surgery in Pakistan. Materials and Methods A retrospective study involving patients who underwent breast cancer surgery from June 2016 to December 2019 was conducted. Perioperative morbidities (30 days) were evaluated and documented. The results obtained were analyzed using the SPSS 23 software (IBM Corporation, Armonk, NY). Results A total of 94 patients were included in the study, with the mean age of 50±12.8 years. Breast conserving surgery was performed in 32% (n=31) of the patients, while the remaining 68% (n=63) underwent modified radical mastectomy. The most common complications were seroma formation, flap necrosis and hematoma formation and were observed in 5.3% (n=5), 4.3% (n=4) and 3.2% (n=3) of the patients, respectively. Conclusion Early postoperative complications can delay the commencement of adjuvant systemic therapy required for further management of breast cancer. These complications elicit equally grave consequences for patients undergoing breast conserving surgery and modified radical mastectomy.