An Advanced Surgical Dressing for High-risk Patients Undergoing Breast Cancer Surgery: A Case-control Study

Abstract

Background: Oncological breast surgeries, classified as breast conserving surgery, oncoplastic surgery, and mastectomies (standard or with tissue sparing and reconstruction), are burdened with an overall complication rate up to 33%. Aquacel Ag Surgical is a combined hydrofiber-hydrocolloids dressing. The aim of this study is to evaluate the incidence of surgical site complications in patients presenting with three or more risk factors (or two, of which at least one classified as "high risk"), undergoing breast cancer surgery with/without reconstruction, comparing advanced (Aquacel Ag Surgical) with traditional dressing. Methods: This is a retrospective, monocentric, case-control study based at the breast unit of the Città della Salute e della Scienza Hospital of Turin, Italy. Fortytwo patients who underwent breast surgeries and met the inclusion criteria were enrolled, from February 1 to July 31, 2018. The primary endpoint was comparing the incidence of surgical site complications (skin alterations, infection, and wound dehiscence) in the two groups. The secondary endpoints were evaluating patient's quality of life, aesthetic outcomes, and compliance to the dressings. Results: The distribution of risk factors at the baseline between the two groups was balanced, without statistically significant differences. Wound complications' incidence at 1 week was lower in the advanced dressing group (P = 0.015). On the bivariate descriptive analysis, advanced dressing proved to be easier to remove for the operator (P = 0.026). The aesthetic outcomes vouched for better scores in the advanced dressing group. Conclusion:In the presented study Aquacel Ag Surgical dressing reduces surgical site complications in the first week after surgery in patients affected by three or more risk factors (or two with at least one classified as "high risk").

Diabetes and Risk of Surgical Site Infection: A Narrative Review

“…These techniques, characterized by smaller incisions and reduced postoperative pain, facilitate earlier mobilization, better preservation of immune function, and decreased reliance on central venous catheters, collectively lowering the risk of SSIs. The World Health Organization's development of evidence-based global guidelines for SSI prevention, focusing on peri-operative management practices such as optimal oxygenation, body temperature maintenance, blood glucose control, and the use of wound protector devices, further underscores the importance of a multifaceted approach to mitigating the risk of SSIs in diabetic patients (1,4,7,22,26,34).…”

“…These techniques, by virtue of smaller incisions, reduced postoperative pain, and better preservation of immune function, contribute significantly to lower SSI incidences. Furthermore, the World Health Organization's emphasis on developing evidence-based global guidelines for SSI prevention, focusing on peri-operative management practices such as optimal oxygenation, maintaining body temperature, and blood glucose control, reinforces the necessity of a holistic approach to managing SSIs (6,24,34,40).…”

“…These techniques, characterized by smaller incisions, earlier mobilization, reduced postoperative pain, better preservation of immune system function, and minimized use of central venous catheters, contribute to the lowered SSI rates. The World Health Organization's focus on developing evidence-based global guidelines for SSI prevention highlights recommendations on peri-operative management, including oxygenation, maintaining body temperature, blood glucose control, and the use of wound protector devices (33)(34)(35)(36).…”