Dressings for the prevention of surgical site infection

Dumville, Jo C; Gray, Trish A; Walter, C.; Sharp, Catherine; Page, Tamara

doi:10.1002/14651858.cd003091.pub3

Cited by 89 publications

(118 citation statements)

References 47 publications

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“…The results are contrary to the opinion of some authors [33][34][35] with whom we disagree. Moreover, the results were better than that described by other authors [30][31][32]36,37].…”

Section: Resultscontrasting

confidence: 99%

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Topical Negative Pressure Therapy and Interactive Dressings in Prevention of Wound Infections in High-Risk Orthopaedic Patients

Vn¹

2016

J Gen Pract

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“…The results are contrary to the opinion of some authors [33][34][35] with whom we disagree. Moreover, the results were better than that described by other authors [30][31][32]36,37].…”

Section: Resultscontrasting

confidence: 99%

“…Sources offer different takes on the clinical and economical efficacy of single-use preventative vacuum assisted dressings: thus some authors consider them viable [30,31] particularly for obese patients [32], others can not discern the difference in the results as compared with standard dressings [33][34][35].…”

Section: Introductionmentioning

confidence: 99%

Topical Negative Pressure Therapy and Interactive Dressings in Prevention of Wound Infections in High-Risk Orthopaedic Patients

Vn¹

2016

J Gen Pract

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“…Among all the comorbidities, diabetes was traditionally considered as a risk factor for SSI in multiple studies, but a study conducted by Dumville JC et al showed that there was no significant effect of diabetes in the occurrence of wound dehiscence. 5 This study also declared similar results.…”

Section: Demographysupporting

confidence: 82%

“…10 The subcutaneous edema gradually resolves in three to seven days, resulting in loosening of sutures. Meanwhile, the bowel edema may increase due to extensive dissection or bowel handling, leading to an increase in intra-abdominal pressure and cutting through of sutures.…”

Section: Ssi (Superficial and Deep)mentioning

confidence: 99%

“…Other complications include deep seated abscess, sepsis (early complications) and high incidence of an incisional hernia (late complications) (69%). [1][2][3][4][5] There have been considerable advances in the management of SSI over the recent years. Early dressing removal is believed be beneficial for early identification of the SSI (both superficial and deep).…”

Section: Introductionmentioning

confidence: 99%

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Early versus late dressing removal in clean and contaminated midline laparotomy wounds: a non-randomized pilot study

et al. 2018

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Background: This study was carried out to evaluate the efficacy of early versus late dressing removal in clean and contaminated midline laparotomy wounds.Methods: Fifty patients aged ≥18 years who were admitted and operated for surgical procedures (both emergency and elective) were included in the study. All laparotomy wounds had fulfilled the CDC criteria. Twenty-five patients each were included in early dressing removal group and the late removal group. In early removal group, the laparotomy wound dressing was removed within 48 hours and in late removal group, was removed after 48 hours of surgery. The incidences of superficial and deep surgical site infection (SSI) in both groups were analysed. Other secondary parameters like incidence of wound dehiscence and secondary suturing were also analysed.Results: Twenty-five patients each, in early removal group and in late removal group were included for final analysis. The incidence of superficial SSI (%) was significantly less in early removal group (65.50 versus 89.50; p= <0.001). The duration (days) required for complete wound healing (8.52 versus 10.65; p=0.734) was significantly less in the early removal group. The length of postoperative hospital stay (days) was significantly less in early removal group (10.30 versus 14.90; p= <0.001).Conclusions: Early removal of dressing significantly reduces the incidence of superficial SSI in midline clean and contaminated laparotomy wounds. It also significantly reduces the duration required for complete wound healing and facilitates early discharge of the patient compared to late dressing removal.

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Optimal Perioperative Care in Major Head and Neck Cancer Surgery With Free Flap Reconstruction

Dort

Farwell

Findlay

et al. 2017

JAMA Otolaryngol Head Neck Surg

367

257

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Importance: Head and neck cancers often require complex, labor-intensive surgeries, especially when free flap reconstruction is required. Enhanced recovery is important in this patient population but evidence-based protocols on perioperative care for this population are lacking. Objective: To provide a consensus-based protocol for optimal perioperative care of patients undergoing head and neck cancer surgery with free flap reconstruction. Evidence Review: Following endorsement by the Enhanced Recovery After Surgery (ERAS) Society to develop this protocol, a systematic review was conducted for each topic. The PubMed and Cochrane databases were initially searched to identify relevant publications on head and neck cancer surgery from 1965 through April 2015. Consistent key words for each topic included "head and neck surgery," "pharyngectomy," "laryngectomy," "laryngopharyngectomy," "neck dissection," "parotid lymphadenectomy," "thyroidectomy," "oral cavity resection," "glossectomy," and "head and neck." The final selection of literature included meta-analyses and systematic reviews as well as randomized controlled trials where available. In the absence of high-level data, case series and nonrandomized studies in head and neck cancer surgery patients or randomized controlled trials and systematic reviews in non-head and neck cancer surgery patients, were considered. An international panel of experts in major head and neck cancer surgery and enhanced recovery after surgery reviewed and assessed the literature for quality and developed recommendations for each topic based on the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) system. All recommendations were graded following a consensus discussion among the expert panel. Findings: The literature search, including a hand search of reference lists, identified 215 relevant publications that were considered to be the best evidence for the topic areas. A total of 17 topic areas were identified for inclusion in the protocol for the perioperative care of patients undergoing major head and neck cancer surgery with free flap reconstruction. Best practice includes several elements of perioperative care. Among these elements are the provision of preoperative carbohydrate treatment, pharmacologic thromboprophylaxis, perioperative antibiotics in clean-contaminated procedures, corticosteroid and antiemetic medications, short acting anxiolytics, goal-directed fluid management, opioid-sparing multimodal analgesia, frequent flap monitoring, early mobilization, and the avoidance of preoperative fasting. Conclusions and Relevance: The evidence base for specific perioperative care elements in head and neck cancer surgery is variable and in many cases information from different surgerical procedures form the basis for these recommendations. Clinical evaluation of these recommendations is a logical next step and further research in this patient population is warranted.

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Dressings for the prevention of surgical site infection

Cited by 89 publications

References 47 publications

Topical Negative Pressure Therapy and Interactive Dressings in Prevention of Wound Infections in High-Risk Orthopaedic Patients

Topical Negative Pressure Therapy and Interactive Dressings in Prevention of Wound Infections in High-Risk Orthopaedic Patients

Early versus late dressing removal in clean and contaminated midline laparotomy wounds: a non-randomized pilot study

Optimal Perioperative Care in Major Head and Neck Cancer Surgery With Free Flap Reconstruction

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