Kosugi Chihiro, Koda Keiji, Shimizu Hiroaki, Yamazaki Masato, Shuto Kiyohiko, Mori Mikito, Usui Akihiro, Nojima Hiroyuki, Endo Satoshi, Yanagibashi Hiroo, Arimitsu Hidehito, Tochigi Toru, Sazuka Tetsutaro, Hirota Mihono, Kuboki Hideyuki
From the Department of Surgery, Teikyo University Chiba Medical Center, Ichihara, Chiba, Japan.
Ann Surg Open. 2024 Mar 14;5(1):e402. doi: 10.1097/AS9.0000000000000402. eCollection 2024 Mar.
To determine whether Aquacel Ag Hydrofiber dressings containing ionic silver are superior to film dressings for preventing superficial surgical site infections (SSI) in patients undergoing elective gastrointestinal surgery.
Multiple clinical trials have assessed the effectiveness of silver-containing wound dressings; however, systematic reviews failed to find any advantages of these dressings and concluded that there was insufficient evidence to indicate that they prevented wound infections. This study aimed to evaluate the efficacy of Aquacel Ag Hydrofiber dressings for preventing superficial SSIs in patients undergoing gastrointestinal surgery.
Patients undergoing elective gastrointestinal surgery were randomly assigned to receive either Aquacel Ag Hydrofiber (study group) or film dressings (control group). The primary end point was superficial SSI within 30 days after surgery (UMIN Clinical Trials Registry ID: 000043081).
A total of 865 patients (427 study group, 438 control group) were qualified for primary end-point analysis. The overall rate of superficial SSIs was significantly lower in the study group than in the control group (6.8% vs 11.4%, = 0.019). There was no significant difference in superficial SSI rates between the groups in patients undergoing upper gastrointestinal surgery; however, the rate was significantly lower in the study group in patients undergoing lower gastrointestinal surgery ( = 0.042). Multivariate analysis identified Aquacel Ag Hydrofiber dressings as an independent factor for reducing superficial SSIs (odds ratio, 0.602; 95% confidence interval, 0.367-0.986; = 0.044).
Aquacel Ag Hydrofiber dressings can reduce superficial SSIs compared to film dressings in patients undergoing elective gastrointestinal surgery, especially lower gastrointestinal surgery.
确定含离子银的藻酸盐银离子水凝胶敷料在预防择期胃肠手术患者浅表手术部位感染（SSI）方面是否优于薄膜敷料。
多项临床试验评估了含银伤口敷料的有效性；然而，系统评价未发现这些敷料有任何优势，并得出结论，没有足够证据表明它们能预防伤口感染。本研究旨在评估藻酸盐银离子水凝胶敷料在预防胃肠手术患者浅表SSI方面的疗效。
将择期胃肠手术患者随机分为接受藻酸盐银离子水凝胶敷料组（研究组）或薄膜敷料组（对照组）。主要终点是术后30天内的浅表SSI（UMIN临床试验注册编号：000043081）。
共有865例患者（研究组427例，对照组438例）符合主要终点分析条件。研究组浅表SSI的总体发生率显著低于对照组（6.8%对11.4%，P = 0.019）。在上消化道手术患者中，两组间浅表SSI发生率无显著差异；然而，在下消化道手术患者中，研究组的发生率显著较低（P = 0.042）。多变量分析确定藻酸盐银离子水凝胶敷料是降低浅表SSI的独立因素（优势比，0.
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