Fight Against Nosocomial Infections

Transcription

1 Fight Against Nosocomial Infections

2 Advanced post-operative dressings help minimize the risk of surgical site infections Philippe Van Overschelde, MD, MSc, MBA AZ Maria-Middelares Ghent, Belgium Fight Against Nosocomial Infections Symposium 2

3 Surgical-wound management challenges Preventing SSIs Supporting patient mobility Managing costs Up to 41% of orthopedic patients suffer from post-op blistering 1 Up to 84% of knee replacement patients are at risk of deep vein thrombosis average increase in healthcare cost if a patient acquires an SSI 3 1. Johansson C. et al. Preventing post-operative blisters following hip and knee arthroplasty. Wounds International, Dela Valle C. et al. Thromboembolism After Hip and Knee Arthroplasty: Diagnosis and Treatment. Journal of American Academy of Orthopedic Surgeons, Jenks P. J. et al. Clinical and economic burden of surgical site infection (SSI) and predicted financial consequences of elimination of SSI from an English hospital. The Journal of Hospital Infections, 2014.

4 Preventing SSI: dressing role Frequent dressing changes Skin damage Barrier Insufficient adhesion

5 Randomized clinical trial to evaluate performance of flexible selfadherent absorbent dressing coated with silicone layer after hip, knee or spinal surgery in comparison to standard wound dressing. Bredow J. et al. Poster presentation at the 5 th WUWHS conference, Florence, Italy, Mepilex Border Post-Op vs Cosmopor E, hip and knee arthroplasty, spine surgery

6 STUDY: Randomized clinical trial to evaluate performance of flexible self-adherent absorbent dressing coated with silicone layer after hip, knee or spinal surgery in comparison to standard wound dressing. Aims: 1. To compare the two on level of post-op skin blistering and maceration 2. To compare wear time Method: A mono center randomized clinical trial n=209

7 Percent % STUDY: Randomized clinical trial to evaluate performance of flexible self-adherent absorbent dressing coated with silicone layer after hip, knee or spinal surgery in comparison to standard wound dressing. Result: 1 No patient suffered from post-op blistering or maceration 2 70 The wear time for Mepilex Border Post-Op was significantly longer Number of dressing changes the first week: 3 The total average weekly cost of wound care was 2,9 less for Mepilex Border Post-Op changes Mepilex Border Post-Op (n=101) Cosmopor (n=103)

8 A randomized controlled trial comparing two wound dressings used after elective hip and knee arthroplasty Van Overschelde Ph. et al. Poster presentation at the 5 th WUWHS conference, Florence, Italy, 2016 Mepilex Border Post-Op vs Aquacel Surgical, hip and knee arthroplasty

9 Participating Clinics Site 1 UZ Ghent Prof. Dr. Hilde Beele Site 2 Medisch Centrum Latem / AZ Maria Middelares, Ghent Dr. Philippe Van Overschelde Site 03 Stockholm South General Hospital Prof. Dr. Sari Ponzer

10 STUDY: A randomized controlled trial comparing two wound dressings used after elective hip and knee arthroplasty Aims: 1. To compare the two wound dressings on dressing wear time 2. To compare the 2 wound dressings on secondary outcoms: Ease of dressing removal Satisfaction during rehabilitation Overall wearing experience Capacity of handling blood Method: Comparative randomized controlled trial n=103

11 Number of dressing changes (ITT Population) Variable A (n=53) B (n=50) Has the dressing been changed No 46 (86.8%) 45 (90.0%) Yes 7 (13.2%) 5 (10.0%) Number of dressing changes 0.2 (0.6) 0.1 (0.4) n=53 n=50 For categorical variables n (%) is presented. For continuous variables Mean (SD) / Median (Min; Max) / n= is presented. Reason for dressing change for both groups Saturation of the dressing

12 Proven secondary outcomes advanced dressing Results A B A B A B Dressin g A B A B 86.8% Never change dressing Good stay on ability 6.9mm Low pain p= No residuals from the dressing p=<.0001 absorption capacity of blood Protect the skin and the wound Good initial absorption capacity p= <.0001 Easy to apply Easy to apply p= Satisfaction of wearing the dressing during rehabilitation training allows movement with the body in a natural way

13 Take home messages Advanced dressings are proven to help minimize SSI Not all dressings are equal! Some have proven clinical superior outcomes (e.g. dressing wear time, early patient mobility and skin protection) Advanced wound care dressings are proven to manage wound care costs well Fight Against Nosocomial Infections Symposium 14

14 Fight Against Nosocomial Infections Symposium 15

15 Merci de votre attention

16 Call for action more info at table with case 9 Fight Against Nosocomial Infections Symposium 17