A randomised control trial using soap in the prevention of surgical site infection in Tanzania | 252 patients in 2 Groups | Open label Randomised trial | 114 Intervention arm (Received a bath with plain soap) | 138 Control arm (No bath) | RESULTS | Intervention arm | 11.4% SSIs | Control arm | 40.6% SSIs | (p<0.01) | Preoperative antibiotics affected the association between the intervention and SSI (p = 0.05) | The bath with plain soap reduced the odds of an SSI by 80% in general | And by 88% in patients without preoperative antibiotics | Conclusion: The use of soap for preoperative bathing significantly decreased the occurrence of SSIs among pediatric surgical patients. This intervention is simple, affordable, and can be implemented on a long-term basis | https://doi.org/10.1016/j.jpedsurg.2022.10.029 | Source: Philipo GS et al. | Department of Paediatric Surgery, Muhimbili National Hospital, Tanzania | @StayCurrentMD | @gigenace | Cincinnati Children's | Journal of Pediatric Surgery
A randomised control trial using soap in the prevention of surgical site infection in Tanzania
Infographic · Apr 2023 · 1 min read
In brief
In brief
Randomized trial in Tanzania demonstrates that simple preoperative bathing with plain soap reduces surgical site infections by 80% in pediatric patients, with even greater benefit (88% reduction) in those not receiving preoperative antibiotics. This cost-effective intervention offers significant potential for low-resource settings.
- Preoperative bathing with plain soap reduced SSI rates from 40.6% to 11.4% in pediatric surgical patients in Tanzania (p<0.01).
- The intervention reduced SSI odds by 80% overall and by 88% in patients not receiving preoperative antibiotics.
- Plain soap bathing is a simple, cost-effective, and sustainable SSI prevention strategy for resource-limited settings.
- Preoperative antibiotics modified the effect of soap bathing on SSI prevention (p=0.05).
- This RCT provides evidence supporting preoperative soap bathing in pediatric surgery guidelines, especially where antibiotic access is limited.
Written by the GCMD Library team from the infographic.
The infographic uses a teal, gray, and yellow color scheme with a calendar icon on the left. The layout flows from top to bottom, showing study design with arrows pointing to two patient groups, followed by results in the middle section, and a yellow conclusion box on the right. Icons and arrows guide the reader through the trial methodology and findings.
Infographic by Dr. Cecilia Gigena
"A randomised control trial using soap in the prevention of surgical site infection in Tanzania"
Authors: Godfrey Sama Philipo, Zaitun Mohamed Bokhary, Neema Lala Bayyo, Soham Bandyopadhyay, Miriam Gerd Pueschel, Rajabu Athumani Bakari, Kokila Lakhoo
Full article: https://www.jpedsurg.org/article/S0022-3468(22)00701-1/fulltext
Abstract
Background
Surgical site infections (SSIs) are common and serious complications of surgery. Guidelines on preventing SSIs have been developed, but the role of preoperative bathing with plain soap among paediatric population is unclear. We aimed to assess the effectiveness of pre-operative bathing using plain soap in preventing SSIs among paediatric surgical patients.
Materials and Methods
An open-label, randomised trial was conducted at Muhimbili National Hospital in Tanzania. Preoperatively, patients in the intervention group washed their body using plain soap, while those in the control group did not. The primary outcome was SSI postoperatively. Statistical tests included χ2, Wilcoxon rank sum, and univariate and multivariable logistic regression.
Results
Of the 252 patients recruited,114 were randomised to the intervention arm. In the control arm, 40.6% (56/138) of participants developed SSIs compared to 11.4% (13/114) in the intervention arm (p < 0.01). After adjusting for confounding factors in multivariable analysis, the intervention reduced the odds of an SSI by 80% (OR: 0.20 [95% CI: 0.10, 0.41]; p < 0.01). Preoperative antibiotics were deemed to be an effect modifier of the association between the intervention and SSI (p = 0.05). The intervention significantly reduced the odds of an SSI by 88% among participants not given preoperative antibiotics (OR: 0.12 [95% CI: 0.05, 0.30]; p < 0.01).
Conclusion
This study has shown that preoperative bathing with soap significantly reduces SSIs in paediatric surgical patients. It is a simple, cost effective and sustainable intervention.