title: Total Occlusive Ionic Silver-Containing Dressing vs Mupirocin Ointment Application vs Conventional Dressing in Elective Colorectal Surgery: Effect on Incisional Surgical Site Infection.
abstract: BACKGROUND
  Several pre- and intraoperative factors have been associated with incisional surgical site infection (SSI), but little is known about the influence of postoperative wound care and especially, the use of different dressings on incisional SSI. The aim of this study was to compare 3 methods of wound dressings (conventional dressing, silver-containing dressing, and mupirocin ointment dressing) for their ability to prevent SSI, as measured by SSI rates, in patients with colorectal cancer undergoing elective open surgery.
  
  
  METHODS
  A prospective, randomized study was performed. Inclusion criteria were diagnosis of colorectal neoplasms and plans to undergo elective surgery with curative aims. Patients were randomized using a 1:1:1 allocation into 3 groups: patients receiving an ionic silver-containing dressing (ISD) (group 1), a mupirocin ointment application (MOA) (group 2), and a conventional dressing (group 3 or standard dressing). The primary outcomes variable was occurrence of incisional SSI. Follow-up was 30 days postoperatively.
  
  
  RESULTS
  A total of 147 patients were included, 49 in each group. Incisional SSI occurred in 9 patients (18.4%) in the ISD group, 2 (4.1%) in the MOA group, and 10 (20.4%) in the standard dressing group (p = 0.028). Adjusting for multiple comparisons, there were no significant differences between ISD and standard dressing groups; a significant difference was observed between ISD and MOA (relative risk [RR] 4.5; 95% CI (1.1 to 19.8); p = 0.046) and between the standard group and the MOA group (RR 5; 95% CI (1.2 to 21.7); p = 0.031).
  
  
  CONCLUSIONS
  Topical application of mupirocin ointment achieves better results for the prevention of SSI than ionic silver-containing dressing or standard dressing in patients undergoing elective open colorectal surgery.
authors.affiliation: Department of Surgery, Hospital Rey Juan Carlos, Madrid, Spain. Electronic address: jruiztovar@gmail.com.
authors.forename: Jaime
authors.initials: J
authors.lastname: Ruiz-Tovar
authors.affiliation: Department of Surgical Nursery, Hospital Sureste, Madrid, Spain.
authors.forename: Carolina
authors.initials: C
authors.lastname: Llavero
authors.affiliation: Department of Surgery, University Hospital Ramon y Cajal, Madrid, Spain.
authors.forename: Vicente
authors.initials: V
authors.lastname: Morales
authors.affiliation: Department of Pathology, Universidad Autónoma de Madrid, Madrid, Spain.
authors.forename: Carlos
authors.initials: C
authors.lastname: Gamallo
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D015179:Colorectal Neoplasms / Q000601:surgery; D003107:Colorectal Surgery; D004311:Double-Blind Method; D017558:Elective Surgical Procedures; D016983:Enterococcus / Q000302:isolation & purification; D004927:Escherichia coli Infections / Q000175:diagnosis / Q000453:epidemiology / Q000517:prevention & control; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D016712:Mupirocin / Q000627:therapeutic use*; D009779:Occlusive Dressings; D009824:Ointments; D011446:Prospective Studies; D012834:Silver / Q000627:therapeutic use*; D013290:Streptococcal Infections / Q000175:diagnosis / Q000453:epidemiology / Q000517:prevention & control; D013530:Surgical Wound Infection / Q000175:diagnosis / Q000453:epidemiology / Q000517:prevention & control*; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents; D009824:Ointments; D012834:Silver; D016712:Mupirocin