The online version of this article (doi:10.1186/1477-7819-10-94) contains supplementary material, which is available to authorized users.
This investigator-initiated trial was conceived by the authors, who also gathered the data, wrote the first and final versions of the manuscript, and decided to submit the paper for publication. All authors vouch for the completeness and accuracy of the data . Medical Researchers of ConvaTec (Princeton, NJ, US), manufacturer of the antimicrobial dressing studied, offered technical support, contributed to the design and conception of the study, and critically revised the manuscript but played no role in data collection or analysis. 'The authors declare that they have no competing interests.
All authors had full access to the data and substantially contributed to the analysis and interpretation of the data and the writing of the manuscript. All authors read and approved the final manuscript.
An antimicrobial dressing containing ionic silver was found effective in reducing surgical-site infection in a preliminary study of colorectal cancer elective surgery. We decided to test this finding in a randomized, double-blind trial.
Adults undergoing elective colorectal cancer surgery at two university-affiliated hospitals were randomly assigned to have the surgical incision dressed with Aquacel® Ag Hydrofiber dressing or a common dressing. To blind the patient and the nursing and medical staff to the nature of the dressing used, scrub nurses covered Aquacel® Ag Hydrofiber with a common wound dressing in the experimental arm, whereas a double common dressing was applied to patients of control group. The primary end-point of the study was the occurrence of any surgical-site infection within 30 days of surgery.
A total of 112 patients (58 in the experimental arm and 54 in the control group) qualified for primary end-point analysis. The characteristics of the patient population and their surgical procedures were similar. The overall rate of surgical-site infection was lower in the experimental group (11.1% center 1, 17.5% center 2; overall 15.5%) than in controls (14.3% center 1, 24.2% center 2, overall 20.4%), but the observed difference was not statistically significant (P = 0.451), even with respect to surgical-site infection grade 1 (superficial) versus grades 2 and 3, or grade 1 and 2 versus grade 3.
This randomized trial did not confirm a statistically significant superiority of Aquacel® Ag Hydrofiber dressing in reducing surgical-site infection after elective colorectal cancer surgery.
Authors’ original file for figure 112957_2012_991_MOESM1_ESM.pdf
Tang R, Chen HH, Wang YL, Changchien CR, Chen JS, Hsu KC, Chiang JM, Wang JY: Risk factors for surgical site infection after elective resection of the colon and rectum: a single-center prospective study of 2,809 consecutive patients. Ann Surg. 2001, 234: 181-189. 10.1097/00000658-200108000-00007. PubMedCentralCrossRefPubMed
National Audit Office: The Management and Control of Hospital-Acquired Infection in Acute NHS Trusts in England. 2007, Her Majesty’s Stationery Office, London
Storm-Versloot MN, Vos CG, Ubbink DT, Vermeulen H: Topical silver for preventing wound infection. Cochrane Database Syst Rev. 2010, 3: CD006478- PubMed
Biffi R, Misitano P, Tadini L, Mancini M, Pace U, Andreoni B: Abdominal surgical site infection and advanced antimicrobial dressings. European Wound Management Association 2007 in Glasgow, Abstracts’ book. 2007, no. 29-
Fujita S, Saito N, Yamada T, Takii Y, Kondo K, Ohue M, Ikeda E, Moriya Y: Randomized, multicenter trial of antibiotic prophylaxis in elective colorectal surgery: single dose vs 3 doses of a second-generation cephalosporin without metronidazole and oral antibiotics. Arch Surg. 2007, 142: 657-661. 10.1001/archsurg.142.7.657. CrossRefPubMed
Yates CC, Whaley D, Babu R, Zhang J, Krishna P, Beckman E, Pasculle AW, Wells A: The effect of multifunctional polymer-based gels on wound healing in full thickness bacteria-contaminated mouse skin wound models. Biomaterials. 2007, 28: 3977-3986. 10.1016/j.biomaterials.2007.05.008. PubMedCentralCrossRefPubMed
Caruso DM, Foster KN, Blome-Eberwein SA, Twomey JA, Herndon DN, Luterman A, Silverstein P, Antimarino JR, Bauer GJ: Randomized clinical study of Hydrofiber dressing with silver or silver sulfadiazine in the management of partial-thickness burns. J Burn Care Rehabil. 2006, 27 (3): 298-309. 10.1097/01.BCR.0000216741.21433.66. CrossRef
Saba SC, Tsai R, Glat P: Clinical evaluation comparing the efficacy of aquacel ag hydrofiber dressing versus petrolatum gauze with antibiotic ointment in partial-thickness burns in a pediatric burn center. J Burn Care Rehabil. 2009, 30: 380-385. 10.1097/BCR.0b013e3181a2898f. CrossRef
Jurczak F, Dugre T, Johnstone A, Offori T, Vujovic Z, Hollander D, AQUACEL Ag Surgical/Trauma Wound Study Group: Randomised clinical trial of Hydrofiber dressing with silver versus povidone-iodine gauze in the management of open surgical and traumatic wounds. Int Wound J. 2007, 4: 66-76. 10.1111/j.1742-481X.2006.00276.x. CrossRefPubMed
Uchiyama K, Takifuji K, Tani M, Ueno M, Kawai M, Ozawa S, Yamaue H: Prevention of postoperative infections by administration of antimicrobial agents immediately before surgery for patients with gastrointestinal cancers. Hepatogastroenterology. 2007, 54: 1487-1493. PubMed
Arnaud JP, Bellissant E, Boissel P, Carlet J, Chastang C, Lafaix C, Rio Y, Berganeschi R: Single-dose amoxycillin-clavulanic acid vs. cefotetan for prophylaxis in elective colorectal surgery: a multicentre, prospective, randomized study. J Hosp Infect. 1992, 22: A23-A32. CrossRef
Tanner J, Woodings D, Moncaster K: Preoperative hair removal to reduce surgical site infection. Cochrane Database Syst Rev. 2006, 2: CD004122- PubMed
Denton GW: Chlorhexidine. Disinfection, Sterilization, and Preservation. Edited by: Block SS. 2001, Lippincott Williams & Wilkins, Philadelphia, 321-336. 5
- Surgical site infections following colorectal cancer surgery: a randomized prospective trial comparing common and advanced antimicrobial dressing containing ionic silver
- BioMed Central
Neu im Fachgebiet Chirurgie
e.Med Kampagnen-Visual, Mail Icon II