Antiseptics and Antibiotics for Surgical Wounds Healing by Secondary Intention: Summary of a Cochrane Review

Clinical Question Do antiseptics and antibiotics benefit surgical wounds healing by secondary intention (SWHSI)?

Bottom Line No high-quality randomized clinical trials have addressed this question. Current evidence is limited and insufficient; it is uncertain whether treating SWHSI with antiseptics or antibiotics is beneficial.

Most surgical incisions are closed with clips or sutures; approximation of cut skin edges helps wounds to heal by “primary intention.” Wounds are left open to heal “by secondary intention” if skin edges cannot be approximated or risk of infection is high. Others become chronic wounds healing by secondary intention after failing to heal by primary intention.

Surgical wounds healing by secondary intention (SWHSI) heal slowly and cause distress, discomfort, and delayed hospital discharge. Current management is high cost: regular dressing changes in hospital or community settings.

Open wounds are prone to microbial colonization and infection, which may affect healing, even without clear signs of infection. Antimicrobial interventions include systemic or topical antibiotics or antiseptics, which aim to kill or slow growth of pathogenic microorganisms. Such treatments can prevent or treat microbial overgrowth; this may accelerate wound healing. To assess whether the use of systemic and topical antibiotics, and antiseptics, is beneficial for the treatment of SWHSI, we conducted a Cochrane Review,1 which is summarized in this article. The primary outcomes were wound healing and wound infection.