Department of Obstetrics, Gynecology, and Women's Health, University of Missouri, Columbia, Missouri, US.
Department of Biostatistics, Loyola University Chicago Health Sciences Division, Maywood, Illinois, US.
J Wound Care. 2022 Jul 1;31(Sup7):S5-S14. doi: 10.12968/jowc.2022.31.Sup7.S5.
To investigate the role of an adherent soft silicone antimicrobial occlusive foam silver-impregnated dressing for reduction of surgical site infections (SSI) in primary low-transverse caesarean section (1°LTCS) delivery.
Women aged 18-45 years admitted to the labour and delivery or the antepartum unit undergoing a 1°LTCS were recruited. Exclusion criteria included repeat caesarean, vertical skin incision, intrapartum fever and closure with staples. Consented participants delivered by scheduled or unscheduled 1°LTCS received the silver-impregnated dressing. Those who declined to participate and were delivered by scheduled or unscheduled caesarean received a standard gauze with tape dressing (controls). Surgical preparation and preoperative antibiotics were administered as per hospital policy.
A total of 362 participants were consented for use of the silver-impregnated dressing, with 190 participants undergoing 1°LTCS, of whom 185 were included in the final analysis. Of those who declined to participate, 190 ultimately underwent 1°LTCS during the same time period. Cases and controls were similar in demographics, body mass index, diabetes status, labour and procedure length, and tobacco use. The overall incidence of SSI was 3.7%. A 50% reduction in incidence of SSI was observed in the silver-impregnated dressing group compared with control group (2.7% versus 4.7%, respectively), but this was not statistically significant (p=0.08; odds ratio 0.55; 95% confidence interval: 0.18-1.67).
Among women undergoing 1°LTCS with subcuticular closure of a transverse incision, use of a silver-impregnated dressing reduced the rate of SSI by >50% but was not statistically significant.
研究黏附性软硅胶抗菌闭合泡沫银浸渍敷料在降低经皮横向剖宫产术（1°LTCS）中手术部位感染（SSI）的作用。
招募年龄在 18-45 岁、在分娩或产前病房接受 1°LTCS 的女性。排除标准包括重复剖宫产、垂直皮肤切口、分娩期发热和使用订书钉缝合。同意接受 1°LTCS 的参与者接受银浸渍敷料，而拒绝参与并接受计划或非计划剖宫产的参与者则接受标准纱布加胶带敷料（对照组）。手术准备和术前抗生素的使用按照医院政策进行。
共有 362 名参与者同意使用银浸渍敷料，其中 190 名接受 1°LTCS，其中 185 名被纳入最终分析。在拒绝参与的参与者中，190 名最终在同一时期接受了 1°LTCS。病例组和对照组在人口统计学、体重指数、糖尿病状况、分娩和手术时间以及吸烟方面相似。SSI 的总发生率为 3.7%。与对照组相比，银浸渍敷料组 SSI 的发生率降低了 50%（分别为 2.7%和 4.7%），但差异无统计学意义（p=0.08；优势比 0.55；95%置信区间：0.18-1.67）。
在经皮横向切口皮内缝合的 1°LTCS 中，使用银浸渍敷料可将 SSI 发生率降低 50%以上，但无统计学意义。
