Open-label clinical trial comparing the clinical and economic effectiveness of using a polyurethane film surgical dressing with gauze surgical dressings in the care of post-operative surgical wounds

Ana Abejón Arroyo, Pabló López Casanova, José Verdú Soriano, Joan-Enric Torra I Bou, Ana Abejón Arroyo, Pabló López Casanova, José Verdú Soriano, Joan-Enric Torra I Bou

Abstract

Surgical site infection (SSI) is a common postoperative complication and can cause avoidable morbidity and excessive costs for the health service. Novel dressings, designed specifically for postoperative wounds, can help to reduce the risk of SSI and other complications such as blistering. This study compared the use of a new polyurethane film surgical dressing (Opsite Post-Op Visible, Smith & Nephew, Hull, UK) with gauze and tape in the management of postoperative wounds. The results show that the polyurethane film dressing results in a significant reduction in SSI (1·4% versus 6·6%, P = 0·006) as well as a reduction in other postoperative wound complications (e.g. blistering and erythema). Economic analysis conducted alongside the study suggests that these improved outcomes can be achieved at a lower treatment cost than gauze and tape dressings. The modest incremental cost of the polyurethane film surgical dressing is easily offset by the reduction in the costs related to treating SSI and other wound complications associated with gauze and tape dressings.

Keywords: Economics; Postoperative; Surgical site infection; Wound.

© 2013 The Authors. International Wound Journal © 2013 Medicalhelplines.com Inc and John Wiley & Sons Ltd.

References

    1. Ducel G, Fabry J, Nicolle L, editors. Prevention of Hospital Acquired Infections: A Practical Guide, 2nd edn. Geneva: World Health Organisation, 2002.
    1. Anderson DJ, Kaye KS, Classen D, Arias KM, Podgorny K, Burstin H, Calfee DP, Coffin SE, Dubberke ER, Fraser V, Gerding DN, Griffin FA, Gross P, Klompas M, Lo E, Marschall J, Mermel LA, Nicolle L, Pegues DA, Perl TM, Saint S, Salgado CD, Weinstein RA, Wise R, Yokoe DS. Strategies to prevent surgical site infections in acute care hospitals. Infect Control Hosp Epidemiol 2008;29(Suppl 1):S51–S61.
    1. Clinical Guideline . Surgical site infections: prevention and treatment of surgical site infection. London: National Institute for Health and clinical Excellence, 2008.
    1. Hurd T, Posnett J. Point prevalence of wounds in a sample of acute hospitals in Canada. Int Wound J 2009;6:287–293.
    1. Drew PD, Posnett J, Rusling L. The cost of wound care for a local population in England. Int Wound J 2007;4:149–155.
    1. Vowden K, Vowden P, Posnett J. The resource costs of wound care in Bradford and Airedale primary care trust in UK. J Wound Care 2009;18:93–102.
    1. Hurd T, Zuillani N, Posnett J. Evaluation of the impact of restructuring wound management practices in a community care provider in Niagara, Canada. Int Wound J 2008;5:295–303.
    1. Stephen‐Haynes J, Bielby A, Searle R. Putting patients first: reducing the human and economic costs of wounds. Wounds UK 2011;7:47–55.
    1. Borkar NB, Khubalkar MV. Are postoperative dressings necessary? J Wound Care 2011;20:301–303.
    1. Chirveches Pérez E, Roca Closa J, Clotet Argemí G, Cantillo‐Vila J, Dot‐Suárez I, Pérez‐Pons A, Rosell‐Cinca F. Apósitos quirúrgicos. Factores asociados a su uso. Rev Rol Enf 2011;34:694–699.
    1. Mangram AJ, Horan TC, Pearson ML, Silver LC, Jarvis WR. The Hospital Infection Control Practices Advisory Committee Guideline for the prevention of surgical site infection. Infect Control Hosp Epidemiol 1999;20:247–280.
    1. Tustanowski J. Effect of dressing choice on outcomes after hip and knee arthroplasty. A literature review. J Wound Care 2009;18:449–459.
    1. Jester R, Russell L, Fell S, Williams S, Prest C. A one hospital study of the effect of wound dressings and other related factors on skin blistering following total hip and knee arthroplasty. J Orthop Nurs 2000;4:71–77.
    1. Coskert T, Elsayed S, Gupta S, Mendonca AD, Tayton KJ. Choice of dressings has a major impact on blistering and healing outcomes in orthopaedic patients. J Wound Care 2005;14:27–29.
    1. Rubio PA. Use of semioclusive, transparent film dressings for surgical wound protection: Experience in 3637 cases. Int Surg 1991;76:235–254.
    1. O'brien G, Buckley K, Vanwaleghem G, Vanrenterghem D, Dharma H, Winter RL, Douglass J. A multi‐centre, prospective, clinical in‐market evaluation to assess the performance of Opsite Post‐op Visible dressings. Int Wound J 2010;7:3.
    1. Winter G. Effect of air exposure and occlusion on experimental human skin wounds. Nature 1963;200:379–380.
    1. Hinman CD, Maibach H. Effect of air exposure and occlusion on experimental human skin wounds. Nature 1963;200:377–378.
    1. Torra i Bou JE, Arboix i Perejamo M, Soldevilla Agreda JJ, Rueda López J, Segovia Gómez T, Martínez Cuervo F, Torres de Castro OG, Galindo Carlos A. Apósitos. In: Soldevilla Agreda JJ, Torra i Bou JE, editors. Atención integral a las heridas crónicas. Madrid, Spain: SPA, 2004.
    1. Downie F, Edgell S, Bielby A, Searle R. Barrier dressings in surgical site infection prevention strategies. Br J Nurs 2010;19:S42–S46.
    1. Horan TC, Gaynes RP, Martone WJ, Jarvis WR, Emori TG. CDC definitions of nosocomial surgical site infections. 1992: a modification of CDC definitions of surgical wound infections. Infect Control Hosp Epidemiol 1992;13:606–608.
    1. Posnett J, Soldevilla Agreda JJ, Torra i Bou JE, Verdú Soriano J, San Miguel L. Una aproximación al impacto del coste económico del tratamiento de las úlceras por presión en España. In: Soldevilla Agreda JJ, Torra i Bou JE, Verdú Soriano J, editors. Epidemiología, coste y repercusiones legales de las úlceras por presión en España, años 2005–2006. Smith & Nephew: San Joan Despí, 2007.
    1. Roberts N, Sorrell J, Bielby A, Searle R. A survey of postoperative wound dressing practice before and after implementing national guidelines. Wounds UK 2011;7:12–21.
    1. Leal A, Kirhy P. Blister formation on primary wound closure sites: a comparison of two dressings. Wounds UK 2008;4:31–37.
    1. Blaylock B, Murray M, O'Connell K, Rex J. Tape injury in the patient with total hip replacement. Orthop Nurs 1995;14:25–28.
    1. Alfonso JL, Blasco Pereperez S, Canoves JM, Martinez MM, Martinez IM, Martin‐Moreno JM. Are we really seeing the total costs of surgical site infections? A Spanish Study. Wound Repair Regen 2007;15:474–481.

Source: PubMed

Sponsoren und Mitarbeiter

Krankheiten

Drogeninterventionen

3
Abonnieren