Silver-Impregnated Dressing Does Not Decrease Incidence of Surgical Site Infection after Adult Cardiac Surgery
| Autor: | Abdul G Chaudhry, Charles D Harr, Judson B. Williams, Bryon J Boulton, Robert Merrill Hunter, Kelly A. Thompson-Brazill, Vignesh Raman, William A Killinger, Kathy Kane |
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| Rok vydání: | 2018 |
| Předmět: |
Adult
Male Pulmonary and Respiratory Medicine Sternum medicine.medical_specialty Silver MEDLINE 030204 cardiovascular system & hematology Cohort Studies 03 medical and health sciences 0302 clinical medicine Humans Surgical Wound Infection Medicine 030212 general & internal medicine Cardiac Surgical Procedures Aged integumentary system business.industry Incidence Incidence (epidemiology) General Medicine Middle Aged Bandages Sternotomy Cardiac surgery Surgery Female Cardiology and Cardiovascular Medicine business Surgical site infection Cohort study |
| Zdroj: | Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery. 13:296-299 |
| ISSN: | 1559-0879 1556-9845 |
| DOI: | 10.1097/imi.0000000000000538 |
| Popis: | Objective Sternal wound infections complicate 1% to 8% of cardiac surgeries and carry significant morbidity. We investigated the utility of silver-impregnated dressing in decreasing sternal wound infections after sternotomy cases. Methods A single-institution cohort study was performed as part of a quality improvement trial of a new sternal dressing. Five hundred fifty-seven sternotomy cases were performed in 2015 with application of a traditional gauze dressing. In 2016, 682 sternotomy cases were performed with the use of a commercially available silver-impregnated dressing. Prospectively identified metrics were analyzed for each patient population along with nursing assessments and structured questionnaires. Results Baseline characteristics of patients in traditional gauze and silver-impregnated dressing groups were similar. Morbidity and mortality were similar. Nine (1.6%) and 12 (1.8%) sternal wound infections were reported in traditional gauze and silver-impregnated dressing groups, respectively. There was no difference in the rate of sternal wound infections ( P = 0.80). The number of organ space infections (3) and deep sternal wound infections (3) was the same; however, the number of superficial infections was greater in the silver-impregnated dressing cohort (3 vs. 6). Among patients in either group with sternal wound infection, there were no differences in the proportion of superficial infections (44% vs. 50%, P = 0.8) or the organism cultured (67% vs. 50% staphylococcus, P = 0.45). A total of 22% of patients reported “not satisfied” with silver-impregnated dressing. Conclusions Silver dressings did not reduce sternal wound infection after sternotomy for cardiac surgery in a large-cohort study. We discontinued the routine use of silver dressings for adult cardiac surgery based on these results because traditional gauze likely represents an equally effective and less costly alternative. |
| Databáze: | OpenAIRE |
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