title: Surgical site infections following colorectal cancer surgery: a randomized prospective trial comparing common and advanced antimicrobial dressing containing ionic silver.
abstract: BACKGROUND
  An antimicrobial dressing containing ionic silver was found effective in reducing surgical-site infection in a preliminary study of colorectal cancer elective surgery. We decided to test this finding in a randomized, double-blind trial.
  
  
  METHODS
  Adults undergoing elective colorectal cancer surgery at two university-affiliated hospitals were randomly assigned to have the surgical incision dressed with Aquacel Ag Hydrofiber dressing or a common dressing. To blind the patient and the nursing and medical staff to the nature of the dressing used, scrub nurses covered Aquacel Ag Hydrofiber with a common wound dressing in the experimental arm, whereas a double common dressing was applied to patients of control group. The primary end-point of the study was the occurrence of any surgical-site infection within 30 days of surgery.
  
  
  RESULTS
  A total of 112 patients (58 in the experimental arm and 54 in the control group) qualified for primary end-point analysis. The characteristics of the patient population and their surgical procedures were similar. The overall rate of surgical-site infection was lower in the experimental group (11.1% center 1, 17.5% center 2; overall 15.5%) than in controls (14.3% center 1, 24.2% center 2, overall 20.4%), but the observed difference was not statistically significant (P = 0.451), even with respect to surgical-site infection grade 1 (superficial) versus grades 2 and 3, or grade 1 and 2 versus grade 3.
  
  
  CONCLUSIONS
  This randomized trial did not confirm a statistically significant superiority of Aquacel Ag Hydrofiber dressing in reducing surgical-site infection after elective colorectal cancer surgery.
  
  
  BACKGROUND
  Clinicaltrials.gov: NCT00981110.
authors.affiliation: Division of Abdomino-Pelvic and Minimally Invasive Surgery, European Institute of Oncology, Via G, Ripamonti, Milan, 435-20141, Italy. roberto.biffi@ieo.it
authors.forename: Roberto
authors.initials: R
authors.lastname: Biffi
authors.forename: Luca
authors.initials: L
authors.lastname: Fattori
authors.forename: Emilio
authors.initials: E
authors.lastname: Bertani
authors.forename: Davide
authors.initials: D
authors.lastname: Radice
authors.forename: Nicole
authors.initials: N
authors.lastname: Rotmensz
authors.forename: Pasquale
authors.initials: P
authors.lastname: Misitano
authors.forename: Sabine
authors.initials: S
authors.lastname: Cenciarelli
authors.forename: Antonio
authors.initials: A
authors.lastname: Chiappa
authors.forename: Liliana
authors.initials: L
authors.lastname: Tadini
authors.forename: Marina
authors.initials: M
authors.lastname: Mancini
authors.forename: Giovanni
authors.initials: G
authors.lastname: Pesenti
authors.forename: Bruno
authors.initials: B
authors.lastname: Andreoni
authors.forename: Angelo
authors.initials: A
authors.lastname: Nespoli
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000890:Anti-Infective Agents / Q000627:therapeutic use*; D001458:Bandages; D002266:Carboxymethylcellulose Sodium / Q000627:therapeutic use*; D015179:Colorectal Neoplasms / Q000473:pathology / Q000601:surgery*; D004311:Double-Blind Method; D004337:Drug Carriers; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D060787:Neoplasm Grading; D011379:Prognosis; D011446:Prospective Studies; D012834:Silver / Q000627:therapeutic use*; D013530:Surgical Wound Infection / Q000517:prevention & control*; D014945:Wound Healing / Q000187:drug effects; D055815:Young Adult
chemical_list: D000890:Anti-Infective Agents; D004337:Drug Carriers; C500574:silverlon; D012834:Silver; D002266:Carboxymethylcellulose Sodium