SSIs are the most common and most costly type of hospital‐acquired infection, occurring in an estimated 160,000 to 300,000 patients in the US each year. SSIs increase morbidity and mortality, result in longer hospital stays and substantially increased cost of care. In fact, it has been demonstrated that a person with an SSI spends on average and extra 9.7 days in the hospital than a person without one, and it’s estimated that 90,000 hospital readmissions per year are due to SSIs. SSIs are painful, cause delayed wound healing, and can lead to sepsis and long‐term disabilities.
The finding that up to 60% of SSIs are preventable has made SSI risk reduction a primary target of intervention.
Staphylococcus aureus, including a large number of methicillin‐resistant strains (MRSA), are endemic in the US and are common causative pathogens in SSIs. While SSIs in general constitute a very serious clinical problem, those caused by MRSA have an even greater impact on patients and hospitals – they tend to be more serious and are associated with higher mortality and longer hospital stays.
Multiple international consensus guidelines agree that preoperative skin antisepsis is an important component of SSI risk reduction care bundles, but there is no similar consensus on post‐op wound care, such as the potential role of antimicrobial postoperative dressings. These have historically included silver‐, or polyhexamethylene biguanide‐impregnated dressings. In fact, a 2016 Cochrane review found inconclusive evidence that postoperative dressings containing silver (Ag) decrease rates of SSI.
CHG has been used as an antiseptic for decades, is effective against a broad spectrum of bacteria, yeast, and some viruses. CHG is commonly used as a skin prep, hand sanitizer, surgical prep, on vascular catheters, in wound care, and is the standard of care for infection prevention in healthcare facilities. CHG‐impregnated IV dressings have been shown to reduce the risk of catheter‐related bloodstream infections, but less is known about the efficacy of CHG‐impregnated post‐op dressings in reducing bacterial bioburden and preventing SSI.
In order to begin to address this knowledge gap, a recent preliminary study sought to determine whether an innovative CHG‐impregnated postoperative dressing (ReliaTect Post‐Op Dressing with CHG) could reduce the bacterial bioburden of MRSA in a porcine incisional wound model. The article, published in the American Journal of Infection Control, is available here.
For this study, ReliaTect was compared to 2 other dressings in a head‐to‐head evaluation of each dressing’s ability to reduce the bioburden of MRSA. ReliaTect, which contains CHG embedded within a transparent acrylic adhesive, was compared to an identical dressing without CHG (placebo dressing) and a gauze pad, representing a common standard of care.
The study was carried out on 6‐9 week old female domestic swine. The animals were anesthetized and the incision area was antiseptically prepared using 2% CHG/70% isopropyl alcohol and draped for surgery.
On each animal, 8 linear full‐thickness incisions were made and then closed with 3 simple sutures. Each closed incision was then challenged with an inoculation of MRSA suspension, and 1 of the 3 postoperative dressings was applied over each incision in a predetermined randomization schedule.
After 72 hours the animals were euthanized and a tissue sample was harvested from each wound. Enumeration of bacterial suspensions from the tissue samples were accomplished by a plate counting technique.
Quantitative analysis recovered zero detectable surviving colony forming units (cfu) of MRSA in any of the 8 incisions covered with ReliaTect (the experimental detection limit was 1.7 log10 cfu/g).
|Dressing||Average microbial recovery (log10 cfu/g)|
|ReliaTect Post‐Op Dressing with CHG||Below detection limit|
*P < 0.001
In contrast, the average microbial recovery from wounds treated with the placebo dressing or gauze dressing was 4.2 log10 cfu/g and 3.2 log10 cfu/g respectively.
This pilot study demonstrated that ReliaTect provided significant antimicrobial activity for 3 days against a multi‐drug resistant strain of Staphylococcus aureus contaminating a surgical wound.
These data are consistent with previous studies demonstrating that CHG dressings can effectively prevent catheter-related infections. The results of this pilot study point to a need for further studies to determine whether CHG post‐op dressings prove to be an effective intervention to reduce the risk of SSI.
Eloquest Healthcare is committed to providing solutions that can help you reduce the risk of hospital-acquired conditions like SSI. For more information about the unique benefits of ReliaTect, please contact your sales consultant or Eloquest Healthcare®, Inc., call 1‐877‐433‐7626 or visit www.eloquesthealthcare.com.
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