A simple item found in almost every medicine cabinet - a cotton swab -- may be a key tool in the fight against post-surgical wound infections.
In a sentinel trial, Cedars-Sinai Medical Center surgeon Shirin Towfigh, MD, showed that painless and gentle probing of a wound with a dry cotton swab after surgery dramatically reduced infections in post-operative incision sites: only 3 percent of patients who had the daily probings contracted infections compared to 19 percent of those who didn't -- a rate more than six times higher than that of the study group.
"That a humble cotton swab could have such an impact in reducing the incidence of hospital-acquired infections is really quite remarkable," Towfigh said. "This study reminds us that scientists can still find effective treatments when we are willing to think outside of the 'technology box.' "
Surgical site infections most commonly occur when patients have "dirty" or contaminated wounds, such as after a trauma, bowel surgery, or perforated appendicitis. Until now, no preventative treatment at the contaminated wound site - including topical antibiotics, under-the-skin wound drains or delayed closure of the wound - has proven to reliably decrease these infections. More than 500,000 such infections occur in the U.S each year, accounting for nearly one-quarter of hospital-acquired infections and a major source of illness and cause of death in patients.
The exact mechanism by which the technique prevents surgical site infection is unclear, though Towfigh and colleagues surmise that wound probing allows contaminated fluid trapped within soft tissues to drain, reducing the bacterial burden while maintaining a moist environment needed for successful wound healing.
Besides greatly reducing incision infections, painless probing with the cotton swab resulted in less post-operative pain for patients and significantly shorter hospital stays (five vs. seven days). Patients also had better cosmetic healing of their incisions and - unsurprisingly -- higher satisfaction with their outcomes.