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PRE-SURGICAL FOOT PREPARATION. IS IT EFFECTIVE?



Abstract

Introduction Foot surgery has an increased risk of postoperative infection when compared with surgery of other anatomical regions. A pre-surgical foot bath in a bactericidal solution is thought to reduce the incidence of postoperative wound infection. We compared the incidence of post-operative wound infection in two groups, one undergoing a pre-surgical footbath and one group that did not.

Method We prospectively assessed 83 patients undergoing forefoot surgery under the care of two surgical teams. Forty-one patients underwent a pre-surgical foot bath in povidone iodine solution. Forty-two patients did not have a pre-surgical foot bath. All patients had microbiological swabs taken on admission and following surgical preparation and draping. These were cultured for bacterial growth. All patients were reviewed at 2 and 6 weeks after surgery and were monitored for signs of infection. The results for each group were analysed and compared.

Results There were seven post-operative infections in the pre-surgical foot bath group. This compared with only two infections for the group who did not undergo pre-surgical bathing. Correlation of infection with complexity of surgery, medical co-morbidities, operative time, method of closure and use of metalwork was examined.

Conclusions These results suggest that pre-surgical bathing in a bactericidal solution is not effective in preventing post-operative infection.

Correspondence should be addressed to BOFSS, c/o Wrightington Wigan and Leigh NHS Trust, Hall Lane, Appley Bridge, Wigan, Lancashire WN7 9EP.