Jeyaraman Madhan, Jeyaraman Naveen, Ramasubramanian Swaminathan, Nallakumarasamy Arulkumar, Murugan Shrideavi, Jayakumar Tarun, Muthu Sathish
Department of Orthopaedics, ACS Medical College and Hospital, Dr MGR Educational and Research Institute, Chennai 600077, Tamil Nadu, India.
Orthopaedic Research Group, Department of Orthopaedics, Coimbatore 641045, Tamil Nadu, India.
Eur Burn J. 2025 Jan 21;6(1):1. doi: 10.3390/ebj6010001.
Surgical site infections (SSIs) are a significant challenge in postoperative care, leading to increased morbidity, extended hospital stays, and elevated healthcare costs. Traditional antimicrobial dressings, such as those containing silver or iodine, have limitations, including cytotoxicity and the potential for antimicrobial resistance. Dialkylcarbamoyl chloride (DACC)-impregnated dressings offer a novel approach, employing a physical mechanism to bind and remove bacteria without the use of chemical agents, thereby reducing the risk of resistance. This review summarizes current evidence on the efficacy of DACC dressings in preventing SSIs and promoting wound healing. Findings from multiple studies indicate that DACC dressings reduce bacterial burden and SSI rates across various surgical procedures, including cesarean sections and vascular surgeries. Additionally, DACC dressings demonstrate potential in managing hard-to-heal wounds, such as diabetic foot ulcers, by reducing bacterial load and biofilm formation. Furthermore, they present advantages in antimicrobial stewardship and cost-effectiveness by minimizing the need for antibiotics and decreasing overall healthcare expenses. However, the current literature is limited by small sample sizes, methodological weaknesses, heterogeneity in study designs, and a lack of long-term data. Future research should focus on high-quality randomized controlled trials across diverse surgical populations, comprehensive cost-effectiveness analyses, and long-term outcomes to establish the full clinical impact of DACC dressings. With further validation, DACC-impregnated dressings could become a critical tool in sustainable postoperative wound care.
手术部位感染(SSIs)是术后护理中的一项重大挑战,会导致发病率增加、住院时间延长以及医疗费用上升。传统的抗菌敷料,如含银或碘的敷料,存在局限性,包括细胞毒性和产生抗菌耐药性的可能性。浸渍二烷基甲酰氯(DACC)的敷料提供了一种新方法,利用物理机制结合并清除细菌,无需使用化学药剂,从而降低耐药风险。本综述总结了关于DACC敷料在预防手术部位感染和促进伤口愈合方面疗效的现有证据。多项研究结果表明,DACC敷料可降低包括剖宫产和血管手术在内的各种外科手术的细菌负荷和手术部位感染率。此外,DACC敷料通过减少细菌载量和生物膜形成,在处理难愈合伤口(如糖尿病足溃疡)方面显示出潜力。此外,它们通过尽量减少抗生素的使用和降低总体医疗费用,在抗菌管理和成本效益方面具有优势。然而,目前的文献受到样本量小、方法学缺陷、研究设计异质性以及缺乏长期数据的限制。未来的研究应侧重于针对不同外科人群的高质量随机对照试验、全面的成本效益分析以及长期结果,以确定DACC敷料的全面临床影响。经过进一步验证,浸渍DACC的敷料可能成为可持续术后伤口护理的关键工具。