• J Arthroplasty · Mar 2017

    Silver-Impregnated Occlusive Dressing Reduces Rates of Acute Periprosthetic Joint Infection After Total Joint Arthroplasty.

    • Matthew J Grosso, Ari Berg, Samuel LaRussa, Taylor Murtaugh, David P Trofa, and Jeffrey A Geller.
    • Center for Hip & Knee Replacement, Department of Orthopaedic Surgery, New York Presbyterian Hospital/Columbia University Medical Center, New York, New York.
    • J Arthroplasty. 2017 Mar 1; 32 (3): 929-932.

    BackgroundCommercial silver-impregnated occlusive dressings (such as AQUACEL® Ag SURGICAL Cover Dressing) have been touted as antimicrobial dressings to be used following total joint arthroplasty. Given the increased cost of an AQUACEL® Ag SURGICAL Cover Dressing over a standard dressing for total joint arthroplasty, the objective of this study was to determine whether AQUACEL® Ag SURGICAL Cover Dressing is effective in reducing the rates of acute periprosthetic joint infection (PJI) compared to standard sterile dressing.MethodsWe retrospectively reviewed the charts of 1173 consecutive patients who underwent a total knee or total hip arthroplasty between 2007 and 2015 by 1 surgeon. The surgeon switched from using a standard xeroform/gauze dressing to an AQUACEL® Ag SURGICAL Cover Dressing in June 2011, with no other major changes in antimicrobial management. Charts were reviewed for evidence of acute PJI (within 3 months of surgery).ResultsThere were a total of 11 cases of acute PJI in this patient cohort (0.94%). The incidence of acute PJI for patients managed with a sterile xeroform dressing was 1.58% (9 of 568 patients), compared to 0.33% (2 of 605 patients) with the use of AQUACEL® Ag SURGICAL Cover Dressing. Univariate analysis showed this to be statistically significant (P = .03), and a multiple logistic regression model supported AQUACEL® Ag SURGICAL Cover Dressing as a protective factor with an odds ratio of 0.092 (95% confidence interval, 0.017-0.490; P = .005).ConclusionThis 4-fold decrease in acute PJI with the use of AQUACEL® Ag SURGICAL Cover Dressing supports the use of silver-impregnated occlusive dressings for the reduction of acute PJI.Copyright © 2016 Elsevier Inc. All rights reserved.

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