Akin Tezcan, Kendirci Murat, Akgün Ali Emre, Çetinkaya Erdinç, Er Sadettin, Akin Merve, Yasti Ahmet Çinar
Department of General Surgery, Ankara City Hospital, Ankara, Turkey.
Hitit University, Medical School, Department of General Surgery, Çorum, Turkey.
Wound Manag Prev. 2022 Apr;68(4):34-43. doi: 10.25270/wmp.2022.4.3443.
Surgical site infections (SSIs) can occur after colorectal surgery. Ionic silver has been used to prevent the development of SSIs. New-generation dressings, defined as total occlusive ionic silver-containing dressings, have been shown to reduce bacterial colonization in SSIs.
To evalute the effect of a silver hydrofiber dressing on the development of SSIs at the abdominal incision after ostomy closure.
There was a total of 37 eligible patients who underwent temporary ostomy closure. Five patients required an associated intervention during ostomy closure and were excluded. One patient was lost to follow-up. Hence, 32 patients were included in the study. Silver-containing occlusive dressings and conventional dressings were used in patients who underwent ostomy closure. In the control group (n = 16), the wound area was covered with a standard sterile gauze dressing for 24 to 48 hours, and then wound cleansing was performed with 10% povidone iodine, followed by daily dressing replacement with sterile gauze for 5 days. The patients in the study group (n = 16) were treated with a silver-containing hydrofiber dressing, which was not changed for 5 days following application in the operating room.
At the end of the 30-day follow-up period, no SSIs were observed in the study group. When the dressing methods applied to the patient groups with and without SSIs were compared, SSIs developed at a higher rate in the control group (n = 4; 26.7%) compared with the study group (n = 0); this result was statistically significant (P = .043).
In this study, the use of a wound care product containing ionic silver reduced the rate of SSIs related to ostomy closure. Multicenter, randomized, clinical studies involving a larger number of patients are needed. In addition, occlusive wound dressings with and without silver should be investigated in further studies.
结直肠手术后可能发生手术部位感染（SSIs）。离子银已被用于预防SSIs的发生。新一代敷料，即完全封闭的含离子银敷料，已被证明可减少SSIs中的细菌定植。
评估银水凝胶敷料对造口关闭后腹部切口处SSIs发生的影响。
共有37例符合条件的患者接受了临时造口关闭术。5例患者在造口关闭期间需要相关干预并被排除。1例患者失访。因此，32例患者被纳入研究。接受造口关闭术的患者分别使用含银封闭敷料和传统敷料。在对照组（n = 16）中，伤口区域用标准无菌纱布敷料覆盖24至48小时，然后用10%聚维酮碘进行伤口清洁，随后每天用无菌纱布更换敷料，持续5天。研究组（n = 16）患者使用含银水凝胶敷料，在手术室应用后5天内不更换。
在30天随访期结束时，研究组未观察到SSIs。比较应用于有或无SSIs患者组的换药方法时，对照组（n = 4；26.7%）发生SSIs的比例高于研究组（n = 0）；该结果具有统计学意义（P = .043）。
在本研究中，使用含离子银的伤口护理产品降低了与造口关闭相关的SSIs发生率。需要开展涉及更多患者的多中心、随机临床研究。此外，应在进一步研究中对含银和不含银的封闭伤口敷料进行调查。
