title: Silver-Impregnated Occlusive Dressing Reduces Rates of Acute Periprosthetic Joint Infection After Total Joint Arthroplasty.
abstract: Commercial silver-impregnated occlusive dressings (such as AQUACEL® Ag SURGICAL Cover Dressing) have been touted as antimicrobial dressings to be used following total joint arthroplasty. Given the increased cost of an AQUACEL® Ag SURGICAL Cover Dressing over a standard dressing for total joint arthroplasty, the objective of this study was to determine whether AQUACEL® Ag SURGICAL Cover Dressing is effective in reducing the rates of acute periprosthetic joint infection (PJI) compared to standard sterile dressing.
  
  
  
  We retrospectively reviewed the charts of 1173 consecutive patients who underwent a total knee or total hip arthroplasty between 2007 and 2015 by 1 surgeon. The surgeon switched from using a standard xeroform/gauze dressing to an AQUACEL® Ag SURGICAL Cover Dressing in June 2011, with no other major changes in antimicrobial management. Charts were reviewed for evidence of acute PJI (within 3 months of surgery).
  
  
  
  There were a total of 11 cases of acute PJI in this patient cohort (0.94%). The incidence of acute PJI for patients managed with a sterile xeroform dressing was 1.58% (9 of 568 patients), compared to 0.33% (2 of 605 patients) with the use of AQUACEL® Ag SURGICAL Cover Dressing. Univariate analysis showed this to be statistically significant (P = .03), and a multiple logistic regression model supported AQUACEL® Ag SURGICAL Cover Dressing as a protective factor with an odds ratio of 0.092 (95% confidence interval, 0.017-0.490; P = .005).
  
  
  
  This 4-fold decrease in acute PJI with the use of AQUACEL® Ag SURGICAL Cover Dressing supports the use of silver-impregnated occlusive dressings for the reduction of acute PJI.
authors: Center for Hip & Knee Replacement, Department of Orthopaedic Surgery, New York Presbyterian Hospital/Columbia University Medical Center, New York, New York.
authors: Matthew J
authors: MJ
authors: Grosso
authors: Center for Hip & Knee Replacement, Department of Orthopaedic Surgery, New York Presbyterian Hospital/Columbia University Medical Center, New York, New York.
authors: Ari
authors: A
authors: Berg
authors: Center for Hip & Knee Replacement, Department of Orthopaedic Surgery, New York Presbyterian Hospital/Columbia University Medical Center, New York, New York.
authors: Samuel
authors: S
authors: LaRussa
authors: Center for Hip & Knee Replacement, Department of Orthopaedic Surgery, New York Presbyterian Hospital/Columbia University Medical Center, New York, New York.
authors: Taylor
authors: T
authors: Murtaugh
authors: Center for Hip & Knee Replacement, Department of Orthopaedic Surgery, New York Presbyterian Hospital/Columbia University Medical Center, New York, New York.
authors: David P
authors: DP
authors: Trofa
authors: Center for Hip & Knee Replacement, Department of Orthopaedic Surgery, New York Presbyterian Hospital/Columbia University Medical Center, New York, New York.
authors: Jeffrey A
authors: JA
authors: Geller
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000890:Anti-Infective Agents; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects* / Q000706:statistics & numerical data; D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects* / Q000706:statistics & numerical data; D001458:Bandages; D005260:Female; D006801:Humans; D007719:Knee Joint; D008297:Male; D008875:Middle Aged; D009779:Occlusive Dressings / Q000706:statistics & numerical data*; D016459:Prosthesis-Related Infections / Q000209:etiology / Q000517:prevention & control*; D012189:Retrospective Studies; D012834:Silver / Q000008:administration & dosage*; D014945:Wound Healing; D055815:Young Adult
chemical_list: D000890:Anti-Infective Agents; D012834:Silver
keywords: Aquacel; dressings; periprosthetic joint infection; total joint arthroplasty