Reducing cardiac surgical site infection: The role of post-op dressing choice

For patients undergoing cardiac operations or surgical procedures, the journey does not end in the operating theatre. The post-operative cardiac period carries its own significant risks. Unfortunately, for some patients, this can mean a surgical site infection (SSI). From extended hospital stays, to life-threatening deep sternal wound infections, surgical site complications (SSCs) are some of the most challenging outcomes for cardiac surgery teams to prevent.

Despite increasing infection control practices and advanced preventative steps, post-operative Surgical Site Infections (SSIs) have a huge impact across all surgeries and remain a significant cause of morbidity, prolonged hospitalisation and death.¹

Why can patients be vulnerable to SSIs?

Several factors combine to make cardiac surgery patients vulnerable to post-operative infection. Firstly, a median sternotomy, the standard approach for open cardiac procedures creates a large wound for the patient. Patients undergoing these procedures are often frequently older and may have comorbidities such as diabetes or obesity. These factors, alongside the complexity and duration of cardiac surgical procedures, contribute to infection incidence rates as high as 26.8%.²

Cardiac surgery surgical site infections (SSIs) are primarily categorised into superficial sternal wound infections (SSWI) and deep sternal wound infections (DSWI).

Deep sternal wound infection (DSWI) is a serious post-operative complication affecting the sternum and surrounding tissue following open cardiac surgery. While reported incidence ranges from 0.2% to 8.0%, the consequences can be severe.³⁻⁴ A meta-analysis found patients with DSWI after cardiac surgical procedures had increased risk of death as well as short- and long-term adverse clinical outcome, adding significant implications to healthcare systems.⁵

Consequences of cardiac wound complications

The consequences of cardiac wound infection are complications that increase the significant deterioration of health or even death. In addition, they prolong the patient’s stay in the hospital and cause additional mental strain.⁶

The right post-op dressing at the right time reduces complications and plays an integral role in successful recovery.

Aquacel™ Ag Surgical™ is the only post-operative dressing combining Hydrofiber™ Technology and Ionic Silver

Aquacel™ Ag Surgical™ helps improve outcomes by creating an optimum healing environment and providing fast broad-spectrum antimicrobial  activity against SSI causing pathogens by utilising ionic silver.

The ionic silver kills broad spectrum pathogens within 30 minutes. You can have the confidence this is occuring whilst your patient is in recovery.⁷ When Aquacel™ Ag Surgical™ meets wound fluid, ionic silver is released both into the dressing and wound-dressing interface. No silver is “dumped” into the incision.

Most of the antimicrobial action will take place within the dressing, acting on microbes that are drawn into the fibres and physically immobilised by unique gelling properties of Hydrofiber® Technology.⁸

By combining exudate management, wound protection and antimicrobial action, Aquacel™ Ag Surgical™ can support post-operative wound care strategies aimed at reducing SSI risk while maintaining patient comfort.

Key finding: In a study of 712 cardiac surgery patients, deep sternal wound infection occurred in 3.4% of patients receiving standard dry dressings — and in zero patients receiving Aquacel™ Ag Surgical™ (P = 0.012). Superficial infection rates were also lower with Aquacel™ Ag Surgical™ (4 vs. 15 cases). Using Aquacel™ Ag Surgical™ dressings significantly reduced deep sternal wound infections after cardiac surgery and may help lower related patient morbidity and healthcare costs.⁹

Driven by an increase in microbial antibiotic resistance and the diminishing prospects of developing new antibiotics¹⁰, topical antimicrobials are being increasingly used in wound care. Aquacel™ Ag Surgical™ is a novel approach supporting antimicrobial stewardship practices.