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01.12.2012 | Research | Ausgabe 1/2012 Open Access

World Journal of Surgical Oncology 1/2012

Surgical site infections following colorectal cancer surgery: a randomized prospective trial comparing common and advanced antimicrobial dressing containing ionic silver

World Journal of Surgical Oncology > Ausgabe 1/2012
Roberto Biffi, Luca Fattori, Emilio Bertani, Davide Radice, Nicole Rotmensz, Pasquale Misitano, Sabine Cenciarelli, Antonio Chiappa, Liliana Tadini, Marina Mancini, Giovanni Pesenti, Bruno Andreoni, Angelo Nespoli
Wichtige Hinweise

Electronic supplementary material

The online version of this article (doi:10.​1186/​1477-7819-10-94) contains supplementary material, which is available to authorized users.

Competing interests

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.

Authors’ contributions

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.

Trial registration NCT00981110
Authors’ original file for figure 1
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