A Randomized Trial of Ionic Silver Dressing to Reduce Surgical Site Infection After Gastrointestinal Surgery

Chihiro Kosugi, MD; Keiji Koda, MD; Hiroaki Shimizu, MD; Masato Yamazaki, MD; Kiyohiko Shuto, MD; Mikito Mori, MD; Akihiro Usui, MD; Hiroyuki Nojima, MD; Satoshi Endo, MD; Hiroo Yanagibashi, MD; Hidehito Arimitsu, MD; Toru Tochigi, MD; Tetsutaro Sazuka, MD; Mihono Hirota, MD; Hideyuki Kuboki, MD

doi:10.1097/AS9.0000000000000402

Annals of Surgery Open (Mar 2024)

A Randomized Trial of Ionic Silver Dressing to Reduce Surgical Site Infection After Gastrointestinal Surgery

Chihiro Kosugi, MD,
Keiji Koda, MD,
Hiroaki Shimizu, MD,
Masato Yamazaki, MD,
Kiyohiko Shuto, MD,
Mikito Mori, MD,
Akihiro Usui, MD,
Hiroyuki Nojima, MD,
Satoshi Endo, MD,
Hiroo Yanagibashi, MD,
Hidehito Arimitsu, MD,
Toru Tochigi, MD,
Tetsutaro Sazuka, MD,
Mihono Hirota, MD,
Hideyuki Kuboki, MD

Affiliations

Chihiro Kosugi, MD: * From the Department of Surgery, Teikyo University Chiba Medical Center, Ichihara, Chiba, Japan.
Keiji Koda, MD: * From the Department of Surgery, Teikyo University Chiba Medical Center, Ichihara, Chiba, Japan.
Hiroaki Shimizu, MD: * From the Department of Surgery, Teikyo University Chiba Medical Center, Ichihara, Chiba, Japan.
Masato Yamazaki, MD: * From the Department of Surgery, Teikyo University Chiba Medical Center, Ichihara, Chiba, Japan.
Kiyohiko Shuto, MD: * From the Department of Surgery, Teikyo University Chiba Medical Center, Ichihara, Chiba, Japan.
Mikito Mori, MD: * From the Department of Surgery, Teikyo University Chiba Medical Center, Ichihara, Chiba, Japan.
Akihiro Usui, MD: * From the Department of Surgery, Teikyo University Chiba Medical Center, Ichihara, Chiba, Japan.
Hiroyuki Nojima, MD: * From the Department of Surgery, Teikyo University Chiba Medical Center, Ichihara, Chiba, Japan.
Satoshi Endo, MD: * From the Department of Surgery, Teikyo University Chiba Medical Center, Ichihara, Chiba, Japan.
Hiroo Yanagibashi, MD: * From the Department of Surgery, Teikyo University Chiba Medical Center, Ichihara, Chiba, Japan.
Hidehito Arimitsu, MD: * From the Department of Surgery, Teikyo University Chiba Medical Center, Ichihara, Chiba, Japan.
Toru Tochigi, MD: * From the Department of Surgery, Teikyo University Chiba Medical Center, Ichihara, Chiba, Japan.
Tetsutaro Sazuka, MD: * From the Department of Surgery, Teikyo University Chiba Medical Center, Ichihara, Chiba, Japan.
Mihono Hirota, MD: * From the Department of Surgery, Teikyo University Chiba Medical Center, Ichihara, Chiba, Japan.
Hideyuki Kuboki, MD: * From the Department of Surgery, Teikyo University Chiba Medical Center, Ichihara, Chiba, Japan.

DOI: https://doi.org/10.1097/AS9.0000000000000402
Journal volume & issue: Vol. 5, no. 1
p. e402

Abstract

Read online

Objective:. To determine whether Aquacel Ag Hydrofiber dressings containing ionic silver are superior to film dressings for preventing superficial surgical site infections (SSI) in patients undergoing elective gastrointestinal surgery. Background:. Multiple clinical trials have assessed the effectiveness of silver-containing wound dressings; however, systematic reviews failed to find any advantages of these dressings and concluded that there was insufficient evidence to indicate that they prevented wound infections. This study aimed to evaluate the efficacy of Aquacel Ag Hydrofiber dressings for preventing superficial SSIs in patients undergoing gastrointestinal surgery. Methods:. Patients undergoing elective gastrointestinal surgery were randomly assigned to receive either Aquacel Ag Hydrofiber (study group) or film dressings (control group). The primary end point was superficial SSI within 30 days after surgery (UMIN Clinical Trials Registry ID: 000043081). Results:. A total of 865 patients (427 study group, 438 control group) were qualified for primary end-point analysis. The overall rate of superficial SSIs was significantly lower in the study group than in the control group (6.8% vs 11.4%, P = 0.019). There was no significant difference in superficial SSI rates between the groups in patients undergoing upper gastrointestinal surgery; however, the rate was significantly lower in the study group in patients undergoing lower gastrointestinal surgery (P = 0.042). Multivariate analysis identified Aquacel Ag Hydrofiber dressings as an independent factor for reducing superficial SSIs (odds ratio, 0.602; 95% confidence interval, 0.367–0.986; P = 0.044). Conclusions:. Aquacel Ag Hydrofiber dressings can reduce superficial SSIs compared to film dressings in patients undergoing elective gastrointestinal surgery, especially lower gastrointestinal surgery.

Published in Annals of Surgery Open

ISSN: 2691-3593 (Online)
Publisher: Wolters Kluwer Health
Country of publisher: United States
LCC subjects: Medicine: Surgery
Website: https://journals.lww.com/aosopen/pages/default.aspx

About the journal