Randomized Controlled Trial: Does the Use of Occlusive Hydrocolloid Silver-Containing Wound Dressing after Sternotomy Reduce Surgical Site Infection after Cardiac Surgery?
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Groups
2.2. Surgical Technique
2.3. Study Outcomes
2.4. Follow-Up and Data Storage
2.5. Statistical Analysis
3. Results
4. Discussion
- (I)
- The patients were blinded until the time of the intervention (application of the bandage after surgery). Due to the nature of this study, it was not possible to conceal the treatment after the procedure, as patients could see their bandages and find out their allocation. Using methods to conceal the dressings (covering with neutral dressing) would have changed the nature of the dressings and affected the treatment. The study team could also see the bandages and was therefore not blinded.
- (II)
- In addition, overestimation of the effect of the dressing on reducing the incidence of SSIs during the design of the study may have resulted in the number of subjects required for this study (n~420) being miscalculated. The number of patients included in the final analysis was even lower (n = 352) due to the predefined exclusion criteria and the “analysis per protocol” design. This may have unintentionally caused our study to be underpowered.
- (III)
- This study was our first experience with the new dressing, which may have led to delays in detecting signs of wound infection. Cost-effective standard sterile gauze and tape are permeable to fluids and gases and retain only small amounts of fluid, allowing early detection of incipient wound secretion and more frequent dressing changes. Aquacel Ag Surgical® has a hydrocolloid adhesive layer and a polyurethane cover. Due to its good occlusion, this absorbent hydrofiber layer can form a moist chamber in the event of increased wound secretion. In the case of consecutive fluid overload, we would recommend a more aggressive approach to changing the hydrocolloid dressing, namely at the first signs of fluid overload, based on our experience with this study.
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
- Pradeep, A.; Rangasamy, J.; Varma, P.K. Recent developments in controlling sternal wound infection after cardiac surgery and measures to enhance sternal healing. Med. Res. Rev. 2021, 41, 709–724. [Google Scholar] [CrossRef] [PubMed]
- Vos, R.J.; Van Putte, B.P.; Kloppenburg, G.T.L. Prevention of deep sternal wound infection in cardiac surgery: A literature review. J. Hosp. Infect. 2018, 100, 411–420. [Google Scholar] [CrossRef]
- Heilmann, C.; Stahl, R.; Schneider, C.; Sukhodolya, T.; Siepe, M.; Olschewski, M.; Beyersdorf, F. Wound complications after median sternotomy: A single-centre study. Interact. Cardiovasc. Thorac. Surg. 2013, 16, 643–648. [Google Scholar] [CrossRef] [PubMed]
- Fu, R.H.; Weinstein, A.L.; Chang, M.M.; Argenziano, M.; Ascherman, J.A.; Rohde, C.H. Risk factors of infected sternal wounds versus sterile wound dehiscence. J. Surg. Res. 2016, 200, 400–407. [Google Scholar] [CrossRef] [PubMed]
- Gorlitzer, M.; Wagner, F.; Pfeiffer, S.; Folkmann, S.; Meinhart, J.; Fischlein, T.; Reichenspurner, H.; Grabenwoeger, M. Prevention of sternal wound complications after sternotomy: Results of a large prospective randomized multicentre trial. Interact. Cardiovasc. Thorac. Surg. 2013, 17, 515–522. [Google Scholar] [CrossRef] [PubMed]
- Lonie, S.; Hallam, J.; Yii, M.; Davis, P.; Newcomb, A.; Nixon, I.; Rosalion, A.; Ricketts, S. Changes in the management of deep sternal wound infections: A 12-year review. ANZ J. Surg. 2015, 85, 878–881. [Google Scholar] [CrossRef] [PubMed]
- Chan, M.; Yusuf, E.; Giulieri, S.; Perrottet, N.; Von Segesser, L.; Borens, O.; Trampuz, A. A retrospective study of deep sternal wound infections: Clinical and microbiological characteristics, treatment, and risk factors for complications. Diagn. Microbiol. Infect. Dis. 2016, 84, 261–265. [Google Scholar] [CrossRef]
- Lytsy, B.; Lindblom, R.P.; Ransjo, U.; Leo-Swenne, C. Hygienic interventions to decrease deep sternal wound infections following coronary artery bypass grafting. J. Hosp. Infect. 2015, 91, 326–331. [Google Scholar] [CrossRef]
- Yavuz, S.S.; Tarcin, O.; Ada, S.; Dincer, F.; Toraman, S.; Birbudak, S.; Eren, E.; Yekeler, I. Incidence, aetiology, and control of sternal surgical site infections. J. Hosp. Infect. 2013, 85, 206–212. [Google Scholar] [CrossRef]
- Jonkers, D.; Elenbaas, T.; Terporten, P.; Nieman, F.; Stobberingh, E. Prevalence of 90-days postoperative wound infections after cardiac surgery. Eur. J. Cardiothorac. Surg. 2003, 23, 97–102. [Google Scholar] [CrossRef]
- Friberg, O.; Svedjeholm, R.; Soderquist, B.; Granfeldt, H.; Vikerfors, T.; Kallman, J. Local gentamicin reduces sternal wound infections after cardiac surgery: A randomized controlled trial. Ann. Thorac. Surg. 2005, 79, 153–161; discussion 161–162. [Google Scholar] [CrossRef] [PubMed]
- Hollenbeak, C.S.; Murphy, D.M.; Koenig, S.; Woodward, R.S.; Dunagan, W.C.; Fraser, V.J. The clinical and economic impact of deep chest surgical site infections following coronary artery bypass graft surgery. Chest 2000, 118, 397–402. [Google Scholar] [CrossRef] [PubMed]
- De Feo, M.; Gregorio, R.; Della Corte, A.; Marra, C.; Amarelli, C.; Renzulli, A.; Utili, R.; Cotrufo, M. Deep sternal wound infection: The role of early debridement surgery. Eur. J. Cardiothorac. Surg. 2001, 19, 811–816. [Google Scholar] [CrossRef] [PubMed]
- Alexander, S.J. Time to get serious about assessing–and managing–psychosocial issues associated with chronic wounds. Curr. Opin. Support. Palliat. Care 2013, 7, 95–100. [Google Scholar] [CrossRef]
- Jenney, A.W.; Harrington, G.A.; Russo, P.L.; Spelman, D.W. Cost of surgical site infections following coronary artery bypass surgery. ANZ J. Surg. 2001, 71, 662–664. [Google Scholar] [CrossRef]
- Hollenbeak, C.S.; Murphy, D.; Dunagan, W.C.; Fraser, V.J. Nonrandom selection and the attributable cost of surgical-site infections. Infect. Control Hosp. Epidemiol. 2002, 23, 177–182. [Google Scholar] [CrossRef]
- Shaikhrezai, K.; Robertson, F.L.; Anderson, S.E.; Slight, R.D.; Brackenbury, E.T. Does the number of wires used to close a sternotomy have an impact on deep sternal wound infection? Interact. Cardiovasc. Thorac. Surg. 2012, 15, 219–222. [Google Scholar] [CrossRef]
- Mangram, A.J.; Horan, T.C.; Pearson, M.L.; Silver, L.C.; Jarvis, W.R. Guideline for prevention of surgical site infection, 1999. Hospital Infection Control Practices Advisory Committee. Infect. Control. Hosp. Epidemiol. 1999, 20, 250–278; quiz 279–280. [Google Scholar] [CrossRef]
- World Health Organization. Global Guidelines for the Prevention of Surgical Site Infection, 2nd ed.; World Health Organization: Geneva, Switzerland, 2018. [Google Scholar]
- Empfehlung der Kommission für Krankenhaushygiene und Infektionsprävention (KRINKO) beim Robert Koch-Institut. Prävention Postoperativer Wundinfektionen. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2018, 61, 448–473. [Google Scholar] [CrossRef]
- Seidelman, J.L.; Mantyh, C.R.; Anderson, D.J. Surgical Site Infection Prevention: A Review. JAMA 2023, 329, 244–252. [Google Scholar] [CrossRef]
- Calderwood, M.S.; Anderson, D.J.; Bratzler, D.W.; Dellinger, E.P.; Garcia-Houchins, S.; Maragakis, L.L.; Nyquist, A.C.; Perkins, K.M.; Preas, M.A.; Saiman, L.; et al. Strategies to prevent surgical site infections in acute-care hospitals: 2022 Update. Infect. Control Hosp. Epidemiol. 2023, 44, 695–720. [Google Scholar] [CrossRef] [PubMed]
- A Summary of Selected New Evidence Relevant to NICE Clinical Guideline 74 ‘Prevention and Treatment of Surgical Site Infection’ (2008); Evidence update 43; National Institute for Health and Care Excellence: London, UK; Manchester, UK, 2013.
- Preventing Surgical Site Infections. Key Recommendations for Practice; Joint Royal College of Surgeons in Ireland/Royal Colleges of Physicians of Ireland Working Group on Prevention of Surgical Site Infection: Dublin, Ireland, 2012.
- Masden, D.; Goldstein, J.; Endara, M.; Xu, K.; Steinberg, J.; Attinger, C. Negative pressure wound therapy for at-risk surgical closures in patients with multiple comorbidities: A prospective randomized controlled study. Ann. Surg. 2012, 255, 1043–1047. [Google Scholar] [CrossRef]
- Teshima, H.; Kawano, H.; Kashikie, H.; Nakamura, K.; Imada, T.; Oda, T.; Aoyagi, S. A new hydrocolloid dressing prevents surgical site infection of median sternotomy wounds. Surg. Today 2009, 39, 848–854. [Google Scholar] [CrossRef] [PubMed]
- Grauhan, O.; Navasardyan, A.; Tutkun, B.; Hennig, F.; Muller, P.; Hummel, M.; Hetzer, R. Effect of surgical incision management on wound infections in a poststernotomy patient population. Int. Wound J. 2014, 11 (Suppl. S1), 6–9. [Google Scholar] [CrossRef] [PubMed]
- Castellano, J.J.; Shafii, S.M.; Ko, F.; Donate, G.; Wright, T.E.; Mannari, R.J.; Payne, W.G.; Smith, D.J.; Robson, M.C. Comparative evaluation of silver-containing antimicrobial dressings and drugs. Int. Wound J. 2007, 4, 114–122. [Google Scholar] [CrossRef]
- Wilkinson, L.J.; White, R.J.; Chipman, J.K. Silver and nanoparticles of silver in wound dressings: A review of efficacy and safety. J. Wound Care 2011, 20, 543–549. [Google Scholar] [CrossRef]
- Walker, M.; Hobot, J.A.; Newman, G.R.; Bowler, P.G. Scanning electron microscopic examination of bacterial immobilisation in a carboxymethyl cellulose (AQUACEL) and alginate dressings. Biomaterials 2003, 24, 883–890. [Google Scholar] [CrossRef]
- Jones, S.A.; Bowler, P.G.; Walker, M.; Parsons, D. Controlling wound bioburden with a novel silver-containing Hydrofiber dressing. Wound Repair. Regen. 2004, 12, 288–294. [Google Scholar] [CrossRef]
- Mohamed, D.S.; Abd El-Baky, R.M.; Sandle, T.; Mandour, S.A.; Ahmed, E.F. Antimicrobial Activity of Silver-Treated Bacteria against other Multi-Drug Resistant Pathogens in Their Environment. Antibiotics 2020, 9, 181. [Google Scholar] [CrossRef]
- Perkasa, D.P.; Arozal, W.; Kusmardi, K.; Syaifudin, M.; Purwanti, T.; Laksmana, R.I.; Pratama, A.A.; Sugoro, I.; Rahayu, D.P. Toxicity and biodistribution of alginate-stabilized AgNPs upon 14-days repeated dose oral administration in mice. J. Appl. Pharm. Sci. 2024, 14, 135–146. [Google Scholar] [CrossRef]
- Berthet, M.; Gauthier, Y.; Lacroix, C.; Verrier, B.; Monge, C. Nanoparticle-Based Dressing: The Future of Wound Treatment? Trends Biotechnol. 2017, 35, 770–784. [Google Scholar] [CrossRef]
- Ahlberg, S.; Meinke, M.C.; Werner, L.; Epple, M.; Diendorf, J.; Blume-Peytavi, U.; Lademann, J.; Vogt, A.; Rancan, F. Comparison of silver nanoparticles stored under air or argon with respect to the induction of intracellular free radicals and toxic effects toward keratinocytes. Eur. J. Pharm. Biopharm. 2014, 88, 651–657. [Google Scholar] [CrossRef]
- Schulz, K.F.; Altman, D.G.; Moher, D. CONSORT 2010 statement: Updated guidelines for reporting parallel group randomised trials. J. Pharmacol. Pharmacother. 2022, 1, 100–107. [Google Scholar] [CrossRef] [PubMed]
- European Centre for Disease Prevention and Control. Point Prevalence Survey of Healthcareassociated Infections and Antimicrobial Use in European Acute Care Hospitals; ECDC: Stockholm, Sweden, 2024. [CrossRef]
- Elver, A.A.; Wirtz, K.; Hu, J.; Daon, E. Treatment of Cardiac Surgical Wounds with Silver Dressings. Kans. J. Med. 2021, 14, 269–272. [Google Scholar] [CrossRef] [PubMed]
- Anderson, D.J.; Kaye, K.S.; Chen, L.F.; Schmader, K.E.; Choi, Y.; Sloane, R.; Sexton, D.J. Clinical and financial outcomes due to methicillin resistant Staphylococcus aureus surgical site infection: A multi-center matched outcomes study. PLoS ONE 2009, 4, e8305. [Google Scholar] [CrossRef]
- Zimlichman, E.; Henderson, D.; Tamir, O.; Franz, C.; Song, P.; Yamin, C.K.; Keohane, C.; Denham, C.R.; Bates, D.W. Health care-associated infections: A meta-analysis of costs and financial impact on the US health care system. JAMA Intern. Med. 2013, 173, 2039–2046. [Google Scholar] [CrossRef]
- Moolla, M.S.; Reddy, K.; Fwemba, I.; Nyasulu, P.S.; Taljaard, J.J.; Parker, A.; Louw, E.H.; Nortje, A.; Parker, M.A.; Lalla, U.; et al. Bacterial infection, antibiotic use and COVID-19: Lessons from the intensive care unit. S. Afr. Med. J. 2021, 111, 575–581. [Google Scholar] [PubMed]
- Meeks, D.W.; Lally, K.P.; Carrick, M.M.; Lew, D.F.; Thomas, E.J.; Doyle, P.D.; Kao, L.S. Compliance with guidelines to prevent surgical site infections: As simple as 1-2-3? Am. J. Surg. 2011, 201, 76–83. [Google Scholar] [CrossRef]
- Umscheid, C.A.; Mitchell, M.D.; Doshi, J.A.; Agarwal, R.; Williams, K.; Brennan, P.J. Estimating the proportion of healthcare-associated infections that are reasonably preventable and the related mortality and costs. Infect. Control Hosp. Epidemiol. 2011, 32, 101–114. [Google Scholar] [CrossRef]
- Schweizer, M.; Perencevich, E.; McDanel, J.; Carson, J.; Formanek, M.; Hafner, J.; Braun, B.; Herwaldt, L. Effectiveness of a bundled intervention of decolonization and prophylaxis to decrease Gram positive surgical site infections after cardiac or orthopedic surgery: Systematic review and meta-analysis. BMJ 2013, 346, f2743. [Google Scholar] [CrossRef]
- Levy, P.Y.; Ollivier, M.; Drancourt, M.; Raoult, D.; Argenson, J.N. Relation between nasal carriage of Staphylococcus aureus and surgical site infection in orthopedic surgery: The role of nasal contamination. A systematic literature review and meta-analysis. Orthop. Traumatol. Surg. Res. 2013, 99, 645–651. [Google Scholar] [CrossRef]
- Tai, Y.J.; Borchard, K.L.; Gunson, T.H.; Smith, H.R.; Vinciullo, C. Nasal carriage of Staphylococcus aureus in patients undergoing Mohs micrographic surgery is an important risk factor for postoperative surgical site infection: A prospective randomised study. Australas. J. Dermatol. 2013, 54, 109–114. [Google Scholar] [CrossRef] [PubMed]
- Tanner, J.; Melen, K. Preoperative hair removal to reduce surgical site infection. Cochrane Database Syst. Rev. 2021, 8, CD004122. [Google Scholar] [CrossRef] [PubMed]
- Espin Basany, E.; Solis-Pena, A.; Pellino, G.; Kreisler, E.; Fraccalvieri, D.; Muinelo-Lorenzo, M.; Maseda-Diaz, O.; Garcia-Gonzalez, J.M.; Santamaria-Olabarrieta, M.; Codina-Cazador, A.; et al. Preoperative oral antibiotics and surgical-site infections in colon surgery (ORALEV): A multicentre, single-blind, pragmatic, randomised controlled trial. Lancet Gastroenterol. Hepatol. 2020, 5, 729–738. [Google Scholar] [CrossRef] [PubMed]
- Berríos-Torres, S.I.; Umscheid, C.A.; Bratzler, D.W.; Leas, B.; Stone, E.C.; Kelz, R.R.; Reinke, C.E.; Morgan, S.; Solomkin, J.S.; Mazuski, J.E.; et al. Centers for Disease Control and Prevention Guideline for the Prevention of Surgical Site Infection, 2017. JAMA Surg. 2017, 152, 784–791. [Google Scholar] [CrossRef] [PubMed]
- Ban, K.A.; Minei, J.P.; Laronga, C.; Harbrecht, B.G.; Jensen, E.H.; Fry, D.E.; Itani, K.M.F.; Dellinger, P.E.; Ko, C.Y.; Duane, T.M. American College of Surgeons and Surgical Infection Society: Surgical Site Infection Guidelines, 2016 Update. J. Am. Coll. Surg. 2017, 224, 59–74. [Google Scholar] [CrossRef]
- Kotagal, M.; Symons, R.G.; Hirsch, I.B.; Umpierrez, G.E.; Dellinger, E.P.; Farrokhi, E.T.; Flum, D.R. Perioperative Hyperglycemia and Risk of Adverse Events Among Patients With and Without Diabetes. Ann. Surg. 2015, 261, 97–103. [Google Scholar] [CrossRef]
- Wang, Y.-Y.; Hu, S.-F.; Ying, H.-M.; Chen, L.; Li, H.-L.; Tian, F.; Zhou, Z.-F. Postoperative tight glycemic control significantly reduces postoperative infection rates in patients undergoing surgery: A meta-analysis. BMC Endocr. Disord. 2018, 18, 42. [Google Scholar] [CrossRef]
- Cabrales, R.A.; Cobo, R.B.; Patiño, Y.D.B.; Quintero, M.F.; Martínez, J.W.; Upegui, M.L.C. Effectiveness of silver dressing in preventing surgical site infections in contaminated wounds. Iatreia 2014, 27, 247–254. [Google Scholar]
- Siah, C.J.; Yatim, J. Efficacy of a total occlusive ionic silver-containing dressing combination in decreasing risk of surgical site infection: An RCT. J. Wound Care 2011, 20, 561–568. [Google Scholar] [CrossRef]
- Borkar, N.B.; Khubalkar, M.V. Are postoperative dressings necessary? J. Wound Care 2011, 20, 301. [Google Scholar] [CrossRef] [PubMed]
- Dumville, J.C.; Gray, T.A.; Walter, C.J.; Sharp, C.A.; Page, T.; Macefield, R.; Blencowe, N.; Milne, T.K.; Reeves, B.C.; Blazeby, J. Dressings for the prevention of surgical site infection. Cochrane Database Syst. Rev. 2016, 12, CD003091. [Google Scholar] [CrossRef] [PubMed]
- Manian, F.A. The role of postoperative factors in surgical site infections: Time to take notice. Clin. Infect. Dis. 2014, 59, 1272–1276. [Google Scholar] [CrossRef] [PubMed]
- Vogt, K.C.; Uhlyarik, M.; Schroeder, T.V. Moist wound healing compared with standard care of treatment of primary closed vascular surgical wounds: A prospective randomized controlled study. Wound Repair. Regen. 2007, 15, 624–627. [Google Scholar] [CrossRef]
- Wynne, R.; Botti, M.; Stedman, H.; Holsworth, L.; Harinos, M.; Flavell, O.; Manterfield, C. Effect of three wound dressings on infection, healing comfort, and cost in patients with sternotomy wounds: A randomized trial. Chest 2004, 125, 43–49. [Google Scholar] [CrossRef]
- Shinohara, T.; Yamashita, Y.; Satoh, K.; Mikami, K.; Yamauchi, Y.; Hoshino, S.; Noritomi, A.; Maekawa, T. Prospective evaluation of occlusive hydrocolloid dressing versus conventional gauze dressing regarding the healing effect after abdominal operations: Randomized controlled trial. Asian J. Surg. 2008, 31, 1–5. [Google Scholar] [CrossRef]
- Dickinson Jennings, C.; Culver Clark, R.; Baker, J.W. A prospective, randomized controlled trial comparing 3 dressing types following sternotomy. Ostomy Wound Manag. 2015, 61, 42–49. [Google Scholar]
- Siddique, K.; Mirza, S.; Housden, P. Effectiveness of hydrocolloid dressing in postoperative hip and knee surgery: Literature review and our experience. J. Perioper. Pr. 2011, 21, 275–278. [Google Scholar] [CrossRef]
- Mazzurco, J.D.; Krach, K.J. Use of a hydrocolloid dressing to aid in the closure of surgical wounds in patients with fragile skin. J. Am. Acad. Dermatol. 2012, 66, 335–336. [Google Scholar] [CrossRef]
- Wilkins, R.G.; Unverdorben, M. Wound cleaning and wound healing: A concise review. Adv. Ski. Wound Care 2013, 26, 160–163. [Google Scholar] [CrossRef]
Criteria for Inclusion in Randomization | Criteria for Exclusion from Analysis |
---|---|
|
|
Control G | Test G | p-Value | |
---|---|---|---|
[N = 172] | [N = 180] | ||
Number of males (%) | 140 (81.4) | 142 (79.8) | 0.593 |
Mean age ± SD | 68.5 ± 9.9 | 67.3 ± 9.1 | 0.241 |
Mean BMI ± SD | 28.1 ± 4.9 | 28.4 ± 4.6 | 0.610 |
Diabetes mellitus (%) | 64 (37.2) | 75 (41.7) | 0.383 |
IDDM (%) | 37 (21.5) | 53 (29.4) | 0.087 |
Chronic pulmonary disease (%) | 20 (11.6) | 15 (8.3) | 0.374 |
Nicotine abuse (%) | 44 (25.6) | 42 (23.3) | 0.710 |
Arterial hypertension (%) | 144 (83.7) | 139 (77.2) | 0.221 |
Hyperlipidemia | 105 (61.0) | 106 (58.9) | 1.000 |
treated with statin | 29 (16.9) | 41 (22.8) | 0.181 |
Peripheral artery disease (%) | 24 (14.0) | 22 (12.2) | 0.752 |
Cerebral vascular disease (%) | 18 (10.5) | 8 (4.4) | 0.041 |
Estimated creatinine clearance | 85.3 ± 29.5 | 81.9 ± 30.0 | 0.289 |
LVEF category | |||
Reduced (30–49%) | 31 (18.0) | 35 (19.4) | 0.785 |
Poor (<30%) | 15 (8.7) | 13 (7.2) | 0.696 |
NYHA | |||
III (%) | 46 (26.7) | 45 (25.0) | 0.808 |
IV (%) | 6 (3.5) | 2 (1.1) | 0.168 |
Median of Euroscore II [IQR] | 1.20% [0.84–2.05] | 1.24% [0.80–1.97] | 0.821 |
Control G | Test G | p-Value | |
---|---|---|---|
[N = 172] | [N = 180] | ||
Combined surgery | 33 (19.2) | 29 (16.1) | 0.488 |
Off-pump surgery | 2 (1.2) | 4 (2.2) | 0.685 |
Count of ITA | |||
sITA | 43 (25.0) | 42 (23.3) | 0.804 |
dITA | 129 (75.0) | 136 (75.6) | 0.804 |
Harvesting technique | |||
classic | 31 (18.0) | 26 (14.4) | 0.469 |
skeletonized (with ultrasound knife) | 141 (82.0) | 152 (84.4) | 0.469 |
Number of anastomoses | 2.8 ± 0.7 | 2.7 ± 0.8 | 0.091 |
Median of skin-to-skin time [IQR] | 228 [196–274] | 226 [191–280] | 0.929 |
Median of ventilation time [IQR] | 9 [7–13] | 9 [6–12] | 0.714 |
Control G | Test G | p-Value | |
---|---|---|---|
[N = 172] | [N = 180] | ||
All SSIs | 15 (8.7) | 19 (10.6) | 0.591 |
superficial SSI | 9 (5.2) | 12 (6.7) | 0.655 |
deep SSI | 6 (3.5) | 7 (3.9) | 1.000 |
mediastinitis | 3 (1.7) | 1 (0.6) | 0.364 |
Surgical revision | 11 (6.4) | 14 (7.8) | 0.680 |
Sternal refixation | 6 (3.5) | 7 (3.9) | 1.000 |
Wound dressing change * | 172 (100.0) | 17 (9.4) | <0.0001 |
excessive wound secretion | - | 5 (2.8) | - |
spontaneous detachment | - | 4 (2.2) | - |
delirium | - | 2 (1.1) | - |
suspicion of allergy | - | 1 (0.6) | - |
application failure | - | 1 (0.6) | - |
CPR | - | 1 (0.6) | - |
of them, SSI ** | - | 1 (0.6) | - |
Disclaimer/Publisher’s Note: The statements, opinions and data contained in all publications are solely those of the individual author(s) and contributor(s) and not of MDPI and/or the editor(s). MDPI and/or the editor(s) disclaim responsibility for any injury to people or property resulting from any ideas, methods, instructions or products referred to in the content. |
© 2024 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
Share and Cite
Chaban, R.; Dohle, K.; Ghazy, A.; Oberhoffer, M.; Vahl, C.-F.; Treede, H.; Oezkur, M. Randomized Controlled Trial: Does the Use of Occlusive Hydrocolloid Silver-Containing Wound Dressing after Sternotomy Reduce Surgical Site Infection after Cardiac Surgery? Life 2024, 14, 1061. https://doi.org/10.3390/life14091061
Chaban R, Dohle K, Ghazy A, Oberhoffer M, Vahl C-F, Treede H, Oezkur M. Randomized Controlled Trial: Does the Use of Occlusive Hydrocolloid Silver-Containing Wound Dressing after Sternotomy Reduce Surgical Site Infection after Cardiac Surgery? Life. 2024; 14(9):1061. https://doi.org/10.3390/life14091061
Chicago/Turabian StyleChaban, Ryan, Kathrin Dohle, Ahmed Ghazy, Martin Oberhoffer, Christian-Friedrich Vahl, Hendrik Treede, and Mehmet Oezkur. 2024. "Randomized Controlled Trial: Does the Use of Occlusive Hydrocolloid Silver-Containing Wound Dressing after Sternotomy Reduce Surgical Site Infection after Cardiac Surgery?" Life 14, no. 9: 1061. https://doi.org/10.3390/life14091061