References
A prospective clinical pilot study comparing two post-operative dressings in the treatment of surgical incisions in volunteers
Abstract
Objective:
Surgical site infections (SSIs) are one of the leading causes of post-operative morbidity and mortality worldwide. The original post-operative dressing, gauze taped in place, did not protect the incision from contamination. A recent clinical trial demonstrated that transparent films were superior to gauze in reducing SSIs. Transparent films are semi-occlusive (semi-permeable, transparent). They protect the incision from contamination; however, one of the drawbacks of current films is that they may become dislodged during daily activities, such as showering. Patients may not realise that the integrity of the dressing has been compromised, leading to soiling of the incision and possible infection. DrySee (DrySee Inc., US) is a novel film dressing with a colorimetric indicator that alerts the patient when the dressing has been compromised.
Method:
This trial compared the film dressing with the indicator (DSD) to a commonly used post-operative dressing comparator (Tegaderm + Pad; 3M, US). A 1.5cm incision was made in the volar forearm of volunteers. The incisions were randomly treated with the DSD or comparator dressing.
Results:
A cohort of 20 volunteer patients was recruited. The DSD had a greater wear time and patients reported that the DSD dressing stayed in place better during activities compared to the comparator.
Conclusion:
Overall, 75% of patients preferred DSD and 25% preferred the comparator.
As many as 4% of patients worldwide suffer from wound complications following surgery, such as surgical site infections (SSIs) and dehisced wounds.1 In addition to the personal suffering, the cost is crippling healthcare systems globally, particularly in low-to-middle-income countries.2 In the US, the National Quality Forum (NQF) classified several SSIs as ‘never events’, refusing to reimburse hospitals for preventable SSIs.3 In an effort to improve identification and prevention of surgical wound complications (SWC) the International Surgical Wound Complication Advisory Panel (ISWCAP), in their 2018 consensus document, identified gaps in evidence in the field. ISWCAP suggested conducting further research into the use of advanced wound care dressings for surgical wounds.4
ISWCAP defines a surgical wound complication as disruption of normal wound healing following surgery.4 The most common source of bacteria in SWCs is skin flora;5 however, a key element in preventing SWCs, the post-operative dressing, has only recently received attention. The first surgical dressings consisted of gauze held in place with adhesive tape. These dressings did not protect the incision from external contamination. The ideal post-operative dressing is semi-permeable and remains intact during normal activities, including showering. One of the improvements in surgical dressing technology, transparent films, are waterproof and allow patients to participate in their routine activities. Several studies suggest that transparent films are superior to gauze.6,7,8 In addition, ISWCAP recommends dressings that allow visual inspection of the incision for the first five post-operative days.4
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