Chaban Ryan, Dohle Kathrin, Ghazy Ahmed, Oberhoffer Martin, Vahl Christian-Friedrich, Treede Hendrik, Oezkur Mehmet
Department of Cardiovascular Surgery, University Hospital of Johannes Gutenberg University Mainz, 55131 Mainz, Germany.
Life (Basel). 2024 Aug 24;14(9):1061. doi: 10.3390/life14091061.
(1) Background: To reduce the incidence of surgical site infections (SSIs) following median sternotomy in cardiac surgery, we compared an occlusive hydrocolloid silver-containing wound dressing (OHSCWD) with a standard wound dressing. (2) Methods: This study was designed as a single-center randomized controlled trial. The primary endpoint was the overall rate of incidence of any kind of SSI. Secondary endpoints were the number of dressing changes, the severity of SSIs, and whether there was a need for treatment. Wounds were monitored daily until the seventh and on the 30th postoperative day. (3) Results: Of the 423 patients included, 352 were analyzed. No differences in demographics, cardiovascular risk factors, intraoperative processes, and postoperative care were found between both groups. Additionally, the incidence or extent of SSI showed no significant differences between the two groups. (4) Conclusions: In summary, out of all pre-, intra-, and postoperative factors, the contribution of postoperative wound care to the development of SSIs appears to play a subordinate role. However, by offering equivalent wound protection and a reduced number of dressing changes, OHSCWD after median sternotomy in cardiac surgery patients could be a good alternative to standard dressings from the point of view of the patient, the staff, and the clinic.
(1) 背景：为降低心脏手术正中开胸术后手术部位感染（SSI）的发生率，我们将含银封闭性水胶体伤口敷料（OHSCWD）与标准伤口敷料进行了比较。(2) 方法：本研究设计为单中心随机对照试验。主要终点是任何类型SSI的总体发生率。次要终点是换药次数、SSI的严重程度以及是否需要治疗。每天对伤口进行监测，直至术后第7天和第30天。(3) 结果：纳入的423例患者中，352例进行了分析。两组在人口统计学、心血管危险因素、术中过程和术后护理方面均未发现差异。此外，两组之间SSI的发生率或程度也无显著差异。(4) 结论：总之，在所有术前、术中和术后因素中，术后伤口护理对SSI发生的影响似乎较小。然而，从患者、医护人员和医疗机构的角度来看，心脏手术患者正中开胸术后使用OHSCWD可提供同等的伤口保护且减少换药次数，是标准敷料的一个良好替代选择。
