Reducing Surgical Site Infections With Silver Impregnated Dressings in Lower Extremity Bypass Patients

Area of Science:

• Vascular Surgery
• Infectious Disease Prevention
• Wound Care

Background:

• Surgical site infections (SSIs) after lower extremity (LE) bypass surgery increase costs and morbidity.
• National SSI rates for LE bypass are high, with institutional rates exceeding national averages.
• Silver-impregnated dressings are used in other specialties to reduce SSIs.

Purpose of the Study:

• To evaluate the impact of transitioning to silver-impregnated dressings on SSI rates in LE bypass surgery.
• To compare SSI rates between patients treated with dry sterile dressings (DSD) and silver-impregnated dressings.

Main Methods:

• Retrospective study of two consecutive LE bypass patient cohorts (2019 DSD, 2020 silver dressings).
• Utilized National Surgical Quality Improvement Program (NSQIP) data and criteria for SSI determination within 30 days.
• Compared SSI rates using Fischer's exact and chi-squared tests.

Main Results:

• A total of 282 patients were analyzed; 168 in the DSD group and 114 in the silver dressing group.
• Superficial SSI rates decreased significantly from 20.8% with DSD to 9.6% with silver dressings (P=0.014).
• No significant differences were observed in deep SSIs, wound dehiscence, readmission, or return to the OR.

Conclusions:

• Silver-impregnated dressings are associated with a statistically significant reduction in superficial SSIs after open LE bypass.
• This intervention is inexpensive and low-risk, suggesting a potential change in clinical practice.
• Further prospective studies are recommended to confirm causality and optimize patient outcomes.