Level 2: Mid-level evidence
In a study of 870 patients who had minor skin excisions and were randomized to wet vs. dry wound management, allowing sutures to get wet 12-48 hours following surgery did not increase the risk of infection (BMJ. 2006;332:1053-1056; full-text available online free of charge at www.bmj.com/cgi/content/full/332/7549/1053. Accessed January 9, 2007). The wet wound management group was instructed to remove the dressing within 12 hours of surgery and bathe as normal until the sutures were removed. The dry wound management group was instructed to keep the wound dry for 48 hours, remove the dressing at 48 hours, and then bathe as usual. Both groups were asked to avoid antiseptic washes and soaps. The outcome assessment was not blinded to treatment assignment. Follow-up was completed by 98.5% of patients. Wound infection (defined as purulent discharge, diagnosis by a general practitioner, or initiation of antibiotics by a general practitioner) occurred in 8.4% of wet group participants vs. 8.9% of dry group participants within 30 days. The statistical likelihood of the wet group’s having a higher rate of infections was <5%.