A prospective two-armed trial assessing the efficacy and performance of a silver dressing used postoperatively on high-risk, clean surgical wounds.
Surgical site infections (SSI) are a known complication of surgery. Silver-containing wound treatments are popular, despite the lack of evidence of SSI reduction. A two-armed study was conducted between July 2007 and November 2008 to evaluate the efficacy and ease of use of a postoperative silver dressing. In the first arm of the study, patients undergoing clean general, vascular, orthopedic, and neurosurgical procedures were allocated to receive a postoperative silver dressing (POSD) or a standard dressing of nonstick gauze under a fluid occlusive dressing. Outcome variables included the incidence of antibiotic initiation for SSI, clinical signs of infection, and leukocyte counts. The second arm of the study was a prospective case series designed to evaluate the performance and handling characteristics of the POSD. Onehundred- ninety-nine (199) patients (mean age 59.2 [range 21-94] years) were enrolled in the first arm of the study. Three out of 99 (3%) patients in the POSD and six out of 100 (6%) control group patients received antibiotic therapy for SSI (P = 0.498). Differences in the percentage of patients with clinical signs of infection following surgery also were not statistically significant (POSD: n = 24, 24.2%; control: n = 30, 30%; P = 0.426). In the second arm, 34 out of 36 patients rated the study dressing easy to apply in (94%), and no pain on removal was noted in 38 out of 57 (66.7%) assessments. No patients in the dressing performance cohort developed an SSI. Prospective, randomized, controlled clinical studies with large sample sizes are warranted to evaluate the efficacy and cost-effectiveness of the POSD.
Mount Sinai St. Luke's Hospital and Mt. Sinai Roosevelt Hospital, New York, NY.
Jamie
J
Schwartz
Mount Sinai St. Luke's Hospital and Mt. Sinai Roosevelt Hospital, New York, NY.
Selena
S
Goss
University of Padua, Padua, Italy.
Federico
F
Facchin
Mount Sinai St. Luke's Hospital and Mt. Sinai Roosevelt Hospital, New York, NY.
Fotini
F
Manizate
Mount Sinai St. Luke's Hospital and Mt. Sinai Roosevelt Hospital, New York, NY.
Cynthia
C
Gendics
Mount Sinai St. Luke's Hospital and Mt. Sinai Roosevelt Hospital, New York, NY.
Elissa
E
Braitman
Mount Sinai St. Luke's Hospital and Mt. Sinai Roosevelt Hospital, New York, NY; email: JLantis@chpnet.org.
John
J
Lantis
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001458:Bandages; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011182:Postoperative Care; D011446:Prospective Studies; D012307:Risk Factors; D012834:Silver / Q000008:administration & dosage*; D013530:Surgical Wound Infection / Q000517:prevention & control*; D055815:Young Adult
D012834:Silver