Efficacy of a total occlusive ionic silver-containing dressing combination in decreasing risk of surgical site infection: an RCT.

OBJECTIVE: To perform a comparative assessment of the efficacy of total occlusive ionic silver-containing dressing (TOISD) combination vs no dressing after colorectal surgery.

METHOD: The surgical sites from both groups were swabbed and sent for culture and sensitivity upon wound closure (superficial incisional skin surface) in the operating theatre, as a baseline for bacterial colonisation. The patients' surgical wounds in the study group were dressed with TOISD combination and the patient's surgical wounds in the control group received the conventional method of no dressing. A second swab was taken from the superficial incisional skin surface for culture and sensitivity investigation between the fifth to seventh postoperative day for comparison of the bacterial colonisation in the two groups.

RESULTS: One-hundred and sixty-six patients were recruited. Six patients dropped out before the fifth postoperative day, leaving 79 patients in the control group and 81 patients in the study group. Microbial swab cultures revealed significant differences between the two groups (p<0.001, mean=1.43±0.63) in bacterial colonisation. The odds ratio (OR) of patients with wounds in the control group was 4.1 (95%CI is 1.884, 8.964) more likely to be contaminated with bacteria compared with wounds covered with occlusive ionic silver-containing dressing.

CONCLUSION: TOISD was found to be effective in reducing bacterial colonisation on the surgical site compared with no dressing. However, it properties were unable to be put into use if there were the surgical sites were not infested with bacterial. Although TOISD might not be necessarily on surgical incisional site not infested with bacteria for the initial post-operation days, it is helpful in preventing further transcription and division for opportunistic bacteria, thus might reduce the risk of superficial incisional SSI. The use of TOSID though statistically insignificant compared to no dressing, could also be possible in reducing the risk and exaceration of deep incisional SSI.