Role of Normal Saline Wound Wash and Subcutaneous Drain in Reducing Laparotomy Wound Infection: A Single-Center Study

Background: Surgical site infections following laparotomy procedures present a major clinical challenge, particularly in developing countries where resources are limited. These infections lead to prolonged hospital stays, increased treatment costs, and significant patient morbidity. Effective yet economical prevention strategies are urgently needed in such healthcare settings. Objective: This study aimed to assess the effectiveness of normal saline wound wash and subcutaneous drain placement in reducing laparotomy wound infections. Methods: We conducted a prospective cross-sectional study on 423 laparotomy patients at Ibn Sina Medical College Hospital, Dhaka, Bangladesh, selected through purposive sampling. The duration of the study was from January 2016 to July 2019. All enrolled patients received standardized normal saline wound irrigation and subcutaneous drain placement per operatively. Surgical site infections were diagnosed using CDC criteria, and data analysis was performed using SPSS version 23.0 with appropriate statistical tests. Results: The study found a 14.2% SSI rate (60/423 cases), with extended subcutaneous drainage (>48 hours) showing significantly lower infections (8.9% vs 19.3%, p=0.002). Diabetes (OR=2.31, p=0.011) and emergency surgery (OR=1.87, p=0.024) were key risk factors. The intervention group had 52% lower SSI risk and shorter hospitalization (5.8 vs 7.3 days, p<0.001) versus controls. Conclusion: Combined normal saline irrigation and subcutaneous drainage effectively reduces laparotomy wound infections in resource-limited settings. This low-cost protocol should be integrated into routine surgical practice, particularly where advanced wound wash is unavailable, to improve outcomes and reduce healthcare burdens