Department of Surgery, Dartmouth-Hitchcock Medical Center, 1 Medical Center Drive, Lebanon, NH 03756, United States.
Geisel School of Medicine, 1 Rope Ferry Road, Hanover, NH 03755, United States.
J Plast Reconstr Aesthet Surg. 2020 Jul;73(7):1306-1311. doi: 10.1016/j.bjps.2020.02.007. Epub 2020 Feb 24.
Optimum timing of postoperative showering varies. Earlier showering improves patient satisfaction, but the impact of the timing of showering on postoperative infection is unclear. We conducted a systematic literature review and meta-analysis to investigate the outcomes of various postoperative showering practices.
We searched PubMed to identify relevant human clinical studies in English, and searched these for additional references. Articles were reviewed for patient demographics, surgical specialty and procedure, wound closure method, placement of drains, showering protocol, and rates of infection and complications. Only randomized controlled trials were analyzed. A random-effects meta-analysis model was used to determine overall infection and complication rates between patients allowed to shower within the first 48 h postoperatively or later.
Out of 357 studies, seven and five were included in the infection and complications rate meta-analyses, respectively. A total of 1,881 and 958 patients were included in each analysis; 605 and 477 patients in each analysis were allowed to shower on or before postoperative day 2 ("early"), while the remainder were prohibited from showering until postoperative day 3 to beyond one week ("delayed") postoperatively. There was no difference in infection (p = 0.45, [-0.0052, 2 × 0.007 95% CI]) or complication rate (p = 0.36, [-0.0046, 2 × 0.005 95% CI]) with earlier vs. delayed showering protocols.
Published literature demonstrates no increase in the overall rate of wound infections or complications when patients showered earlier in the postoperative period. Additional randomized studies are needed to determine the ideal time for postoperative showering. These data should be considered by surgeons while determining when to permit patients to shower after surgery.
术后淋浴的最佳时间因人而异。较早淋浴可提高患者满意度，但淋浴时间对术后感染的影响尚不清楚。我们进行了系统的文献回顾和荟萃分析，以调查各种术后淋浴实践的结果。
我们在 PubMed 中搜索英文相关的人类临床研究，并对这些研究进行了额外的参考文献搜索。文章回顾了患者人口统计学、手术专业和程序、伤口闭合方法、引流管放置、淋浴方案以及感染和并发症的发生率。仅分析随机对照试验。使用随机效应荟萃分析模型来确定允许术后 48 小时内或更晚淋浴的患者之间的总感染和并发症发生率。
在 357 项研究中，有 7 项和 5 项分别纳入了感染和并发症发生率的荟萃分析。每个分析共纳入 1881 名和 958 名患者；每个分析中，有 605 名和 477 名患者允许在术后第 2 天或之前淋浴（“早期”），其余患者则禁止淋浴直至术后第 3 天或超过一周（“延迟”）。早期与延迟淋浴方案相比，感染率（p=0.45，[-0.0052，2×0.00795%CI]）或并发症发生率（p=0.36，[-0.0046，2×0.00595%CI]）没有差异。
已发表的文献表明，患者在术后早期淋浴不会增加伤口感染或并发症的总体发生率。需要更多的随机研究来确定术后淋浴的理想时间。这些数据应在外科医生确定何时允许患者术后淋浴时予以考虑。
