Role of Normal Saline Irrigation Prior to Closure of Surgical Wound to Reduce Surgical Site Infection in Gynaecologic Oncologic Surgery

Open Access

Abstract

Background: Surgical site infection (SSI) is a major cause of postoperative morbidity and increased healthcare burden in gynaecologic oncologic surgery. Patients with gynaecological malignancies face a higher SSI risk due to prolonged surgery, tissue dissection and immune compromise. Wound irrigation with saline before closure may reduce bacterial contamination and prevent SSI; however, evidence from low- and middle-income countries remains limited.  Objective: This study evaluated the role of normal saline wound irrigation in reducing SSI among patients undergoing gynaecologic oncologic surgery. Methods & Materials: A comparative observational study was conducted at the Department of Gynecological Oncology, Bangladesh Medical University (BMU), Dhaka, from June 2024 to July 2025. The study included 100 patients: 50 receiving preoperative normal saline wound irrigation and 50 controls. Sociodemographic, clinical, operative and postoperative data were analyzed using SPSS version 25.0. Results: The groups were comparable in terms of baseline characteristics, surgery type and operative factors. The SSI rate within 30 days was lower in the irrigation group (10%) than in the control group (30%) (p=0.012). SSI at 10 days (8% vs. 26%, p=0.018) and 30 days (6% vs. 22%, p=0.027), wound discharge (6% vs. 20%, p=0.034), febrile illness (8% vs. 24%, p=0.028), additional antibiotics (6% vs. 22%, p=0.027) and hospital stay (4.8 ± 1.3 vs. 6.4 ± 1.9 days, p=0.001) were reduced with irrigation. Conclusion: Normal saline wound irrigation before closure significantly reduced SSI rates and complications in gynaecologic oncologic surgery, representing an effective preventive measure.