Bua Nelson, Smith George E, Totty Joshua P, Pan Daniel, Wallace Tom, Carradice Daniel, Chetter Ian C
Academic Vascular Surgical Unit, Hull York Medical School, Hull, UK.
Academic Vascular Surgical Unit, Hull York Medical School, Hull, UK.
Ann Vasc Surg. 2017 Oct;44:387-392. doi: 10.1016/j.avsg.2017.03.198. Epub 2017 May 5.
Dressings coated with dialkylcarbamoyl chloride (DACC) are highly hydrophobic and irreversibly bind multiple types of bacteria, trapping them in the dressing and reducing the number of organisms at the wound surface. We aimed to assess the impact of DACC-coated postoperative dressings on the incidence of surgical site infection (SSI) in nonimplant vascular surgery patients.
Two hundred patients undergoing nonimplant vascular surgery were prospectively recruited at a single vascular center. The initial 100 patients had their operative wounds dressed with conventional dressings followed by 100 patients who received DACC-coated postoperative dressings. Wounds were reviewed at day 5 and day 30 to determine the presence of SSI using the ASEPSIS scoring system. The variation in outcomes between groups was assessed using chi-squared test and logistic regression analysis to assess the effects of other variables, which may affect healing.
Between August 1, 2015 and February 29, 2016, a total of 120 men and 80 women were recruited. The mean age was 63 (range 27-97) years, 92% were current or ex-smokers and 45.5% were diabetic. Rate of SSI at 5 days was significantly lower in the DACC group compared with standard dressings (1% vs. 10%, P < 0.05). There was no difference in the rates of SSI at 30 days. Logistic regression suggested that the type of dressing used was the most prominent predictor variable for the presence of early SSI (P = 0.028, odds ratio = 0.09, 95% confidence interval: 0.01-0.77).
DACC-coated dressings were associated with a significant reduction in SSI rates in the early postoperative period.
涂有二烷基碳酰氯（DACC）的敷料具有高度疏水性，能不可逆地结合多种类型细菌，将它们困在敷料中并减少伤口表面的微生物数量。我们旨在评估涂有DACC的术后敷料对非植入性血管手术患者手术部位感染（SSI）发生率的影响。
在单一血管中心前瞻性招募200例接受非植入性血管手术的患者。最初的100例患者用传统敷料包扎手术伤口，随后的100例患者接受涂有DACC的术后敷料。在第5天和第30天对伤口进行检查，使用ASEPSIS评分系统确定是否存在SSI。使用卡方检验和逻辑回归分析评估组间结果的差异，以评估可能影响愈合的其他变量的影响。
在2015年8月1日至2016年2月29日期间，共招募了120名男性和80名女性。平均年龄为63岁（范围27 - 97岁），92%为当前吸烟者或既往吸烟者，45.5%患有糖尿病。与标准敷料相比，DACC组第5天的SSI发生率显著更低（1%对10%，P < 0.05）。第30天的SSI发生率无差异。逻辑回归表明，所用敷料类型是早期SSI存在的最显著预测变量（P = 0.028，比值比 = 0.09，95%置信区间：0.01 - 0.77）。
涂有DACC的敷料与术后早期SSI发生率的显著降低相关。
