O17 - A randomized, prospective study of surgical site infections following vascular reconstructive surgery: untreated vs. silver-impregnated dressings
Author(s):
Amani Politano, Margaret Tracci, David Strider, Robert Sawyer, John Kern, Gilbert Upchurch, Kenneth Cherry, University of Virginia
Background: Surgical site infections (SSIs) can lead to significant comorbidities, especially in vascular patients, and particularly in the setting of synthetic conduits and distal incisions.
Hypothesis: We hypothesized that post-operative placement of silver-impregnated dressings would decrease the incidence of SSIs following vascular reconstructions.
Methods: This trial was a randomized controlled open label study of standard untreated surgical dressings (Primapore™, smith&nephew, PP) versus silver-impregnated dressings (Therabond 3D®, Choice Therapeutics, AG+) in patients undergoing aortic or infrainguinal vascular procedures between August 2010 and November 2011. Randomization was performed by sequential block method. Prospective collection of patient demographics, operative and post-operative details, wound healing, and subsequent interventions were performed.
Results: One hundred forty five patients were enrolled; 70 received AG+, 75 PP. There were no differences in basic demographics or comorbid conditions, excepting more black patients in the AG+ group. Type of operation did not differ significantly. Patients wore AG+ longer than PP per the study protocol. The total number of infections in AG+ was 25 (20.3%) compared to 19 (17.1%) in the PP group (NS), and did not vary by type of infection (table). Treatments for infection also did not differ.
Conclusions: The use of silver in dressings, topical treatments, and other modalities reduces infections in some settings. However, in this study evaluating patients undergoing vascular reconstructive surgery with AG+ compared to PP, no significant reduction in rates of SSI was noted. The addition of silver in this form to a wound dressing covering surgically closed wounds is unlikely to improve outcomes to a clinically significant degree.