Surgical site infections following colorectal cancer surgery: a randomized prospective trial comparing common and advanc
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RESEARCH
WORLD JOURNAL OF SURGICAL ONCOLOGY
Open Access
Surgical site infections following colorectal cancer surgery: a randomized prospective trial comparing common and advanced antimicrobial dressing containing ionic silver Roberto Biffi1*, Luca Fattori2, Emilio Bertani3, Davide Radice4, Nicole Rotmensz4, Pasquale Misitano1, Sabine Cenciarelli1, Antonio Chiappa3, Liliana Tadini5, Marina Mancini5, Giovanni Pesenti2, Bruno Andreoni3 and Angelo Nespoli2
Abstract Background: An antimicrobial dressing containing ionic silver was found effective in reducing surgical-site infection in a preliminary study of colorectal cancer elective surgery. We decided to test this finding in a randomized, double-blind trial. Methods: Adults undergoing elective colorectal cancer surgery at two university-affiliated hospitals were randomly assigned to have the surgical incision dressed with AquacelW Ag Hydrofiber dressing or a common dressing. To blind the patient and the nursing and medical staff to the nature of the dressing used, scrub nurses covered AquacelW Ag Hydrofiber with a common wound dressing in the experimental arm, whereas a double common dressing was applied to patients of control group. The primary end-point of the study was the occurrence of any surgical-site infection within 30 days of surgery. Results: A total of 112 patients (58 in the experimental arm and 54 in the control group) qualified for primary endpoint analysis. The characteristics of the patient population and their surgical procedures were similar. The overall rate of surgical-site infection was lower in the experimental group (11.1% center 1, 17.5% center 2; overall 15.5%) than in controls (14.3% center 1, 24.2% center 2, overall 20.4%), but the observed difference was not statistically significant (P = 0.451), even with respect to surgical-site infection grade 1 (superficial) versus grades 2 and 3, or grade 1 and 2 versus grade 3. Conclusions: This randomized trial did not confirm a statistically significant superiority of AquacelW Ag Hydrofiber dressing in reducing surgical-site infection after elective colorectal cancer surgery. Trial registration: Clinicaltrials.gov: NCT00981110 Keywords: Colorectal cancer, Elective surgery, Hydrofiber dressing, Ionic silver, Surgical site infection
* Correspondence: [email protected] 1 Division of Abdomino-Pelvic and Minimally Invasive Surgery, European Institute of Oncology, Via G. Ripamonti, Milan 435-20141, Italy Full list of author information is available at the end of the article © 2012 Biffi et al.; licensee BioMed Central Ltd This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Biffi et al. World Journal of Surgical Oncology 2012, 10:94 http://www.wjso.com/content/10/1/94
Background Surgical-site infection (SSI) occurs in 300,000 to 500,000 patients who undergo surgery in the US eac
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