Impact of an antimicrobial dressing in reducing surgical site infections in cardiac surgery patients.

UNLABELLED xBxxaxcxkground. In addition to prevention guidelines already in place, the effectiveness of an antimicrobial dressing on the occurrence of surgical site infections (SSIs) among adult patients undergoing cardiac surgery was evaluated. METHODS A house-wide replacement of the plain postoperative gauze dressing with a sterile dressing impregnated with 0.2% polyhexamethylene biguanide directly on the incision after closure in the operation room was performed. From May 2005 to March 2007, 1658 patients were enrolled in this study. Surgical site infections were identified using the Centers for Disease Control and Prevention standard criteria. RESULTS Of the 1658 patients enrolled, 1399 patients were included in the analysis, 692 with the plain dressing and 707 with antimicrobial dressing. The overall and leg site infection rate was significantly higher in the plain dressing group compared to the antimicrobial group but similar in the sternal site. Overall, the antimicrobial dressings significantly reduced infection (OR 0.58 [0.38-0.89]). Obesity was also a strong independent predictor of SSI regardless of the site of surgery. Increasing age at surgery and left ventricular ejection fraction of 30%-49% were also independent predictors of infection. CONCLUSION The antimicrobial dressing had a positive effect by reducing the infection rate, especially for leg incisions using conventional open techniques, and could be a worthwhile addition in conjunction with a strategic program. .