The Effectiveness of Sterile Wound Drapes in the Prevention of Surgical Site Infection in Thoracic Surgery

Abstract

Background. The rate of surgical site infections (SSIs) has decreased in parallel to advances in sterilization techniques. Such infections increase morbidity and hospitalization costs. The use of iodine-impregnated sterile wound drapes (SWDs) is recommended to prevent or reduce the incidence of these infections. However, there is a paucity of data regarding their use in thoracic surgical procedures. The aim of the present study was to evaluate the effectiveness of sterile wound drapes in the prevention of these infections and the effects on hospitalization costs. Methods. Perioperative iodine-impregnated SWDs have been used since January 2015 in the Thoracic Surgery Clinic of our hospital. A retrospective evaluation was made of patients who underwent anatomic pulmonary resection via thoracotomy with SWD in the period January 2015–2017, compared with a control group who underwent the same surgery without SWD in the 2-year period before January 2015. Factors that may have increased the risk of surgical site infection were documented and the occurrence of SSI was recorded from postoperative follow-up data. The cost analysis was performed as an important criterion to investigate the benefits of SWD. Results. Evaluation was made of 654 patients in the study group (n:380) using SWD, the operation time was significantly longer, and perioperative blood transfusion was significantly higher, whereas treatment costs (p=0.0001) and wound culture positivity (p=0.004) were significantly lower and less surgical wound debridement was performed (p=0.002). Conclusion. The findings suggest that the use of sterile wound draping in thoracic surgery procedures reduces surgical site infections and hospitalization costs.

Surgical Site Infections Are Associated With Higher Blood Loss and Open Access in General Thoracic Practice

“…The overall SSI rate was 1.5%, which reflects current literature rates mentioned above (6)(7)(8)(9)(10)(11). There is no consensus on criteria for the diagnosis of SSI (1,4,18). Up to 41 SSI definitions are reported in the literature.…”

“…SSIs are defined by the United States Centers for Disease Control and Prevention (CDC) as "an infection that occurs after surgery in the part of the body where the surgery took place" (15). Superficial SSIs involve only the skin and subcutaneous tissue while deep SSIs affect tissues under the skin like muscle, fascia, adjacent organs/space opened, or manipulated during the operation or foreign body (15)(16)(17)(18).…”

The Socioeconomic Impact of Surgical Site Infections

“…Beyond the expected benefit for the patient, this report can and should serve as new arguments for public authorities to invest in the prevention of SSIs. An old and recent study on the cost-effectiveness analysis of preventive measures in surgery can be found in the literature (31)(32)(33).…”

Use of iodine-impregnated surgical drapes for prevention of surgical site infection: a systematic review and meta-analysis

“…Karapinar (2019) 20 and Hagen (1995) 13 have a high risk of bias as the intervention and control occurred over different time periods and Hagen (1995) 13 notes a significant increase in operative and cardiopulmonary bypass pump time in the control group. Yoshimura (2003) 15 has moderate confounding bias, as there was variation in the antiseptic skin preparation solution and the laparotomy incision approach.…”