3 Kasım 2014 Pazartesi
Hospital Adoption of Advanced Wound Dressing Leads to Substantial Clinical and Cost Benefits
GREENSBORO, NC (November 3, 2014) – A new retrospective study has found that use of AQUACEL® Ag SURGICAL cover dressing resulted in a significant reduction in the rate of deep sternal wound infection (DSWI) in patients who undergo cardiac surgery. The study was presented at the 2014 Eastern Cardiothoracic Surgical Society Annual Meeting held October 8-11 in Palm Beach, FL.
"Deep sternal wound infection is a major healthcare threat as well as a serious economic concern," said Scott Schubach, MD, author of the study, Chairman of the Department of Thoracic and Cardiovascular Surgery at Winthrop Hospital, Mineola, NY, and Assistant Professor of Clinical Surgery at Stony Brook School of Medicine, Stony Brook, NY.
DSWI is a life-threatening post-operative complication in cardiac surgery with an incidence of one to five percent. Patients with DSWI die at a rate that is twice that of those without this complication. These patients require a much more aggressive treatment regimen consisting of early surgical debridement with subsequent coverage using the patient’s tissue cells and long-term intravenous antibiotics. Consequently, patients with sternal wound complications accumulate an average of 20 additional hospital days and incur an estimated 2.8 times the cost of patients with uncomplicated postoperative courses.
In addition, under provisions of the Affordable Care Act intended to improve healthcare quality, DSWIs are typically considered hospital acquired conditions (HACs) and can result in payment penalties under Medicare.
At Winthrop, DWSI added approximately $60K to the cost of care per affected patient. “We were experiencing increasing infection rates during cardiac surgeries and needed to address the situation,” said Dr. Schubach. “We knew that our orthopedic colleagues were using AQUACEL® Ag SURGICAL cover dressing with great results. As our study findings show, none of our patients treated with AQUACEL® Ag SURGICAL cover dressing experienced a DSWI. The simple use of the new dressing played a vital role in reducing the treatment and financial burdens we faced due to DSWI.”
The retrospective study included data reviewed from consecutive patients aged between 19 and 89 years who were admitted for cardiac surgery from August 2009 through June 2013. During this period, the hospital changed practice from use of dry sterile dressings to AQUACEL® Ag dressings. All other procedures remained constant during the evaluation period.
A retrospective consecutive cohort of 504 patients underwent cardiac surgery via median sternotomy from August 2009 through May 2011.Their sternotomy incision was covered with dry, sterile 4”X4”/10X10cm dressings and tape and changed daily after the first post-operative day.
They were compared with a consecutive cohort of 208 patients who underwent cardiac surgery via median sternotomy from May 2011 through June 2013. These patients had their sternotomy incision covered with AQUACEL® Ag SURGICAL cover dressing placed intra-operatively and worn for five to seven days. The dressing was changed utilizing sterile technique if it became soiled.
The 208 patients were followed for 30 days post-discharge from the hospital for development of either deep or superficial sternal wound infection. The two groups were compared by demographic and clinical characteristics to confirm group comparability.
Results of the study found that the rate of DSWI dropped from 3.4% using standard dressings following cardiac surgery (17 of 504 cases studied) to 0 % with AQUACEL® Ag SURGICAL (0 of 208 cases). This difference was statistically significant by Fisher’s exact test (P=0.012).
(Link to study poster here: http://convatec.com/media/13099683/winthropposter.pdf)
AQUACEL® Ag SURGICAL cover dressing combines a proprietary Hydrofiber® Technology wound contact layer with the skin-like flexibility of DuoDERM™ Technology. The advanced antimicrobial cover dressing is designed to protect surgical incisions with a waterproof viral and bacterial barrier that also allows for greater range of motion and comfort after surgery.
AQUACEL® dressings with Hydrofiber® Technology, exclusively from ConvaTec, gel on contact with wound exudate, providing clinicians and patients with substantial wound care benefits. As demonstrated in vitro, this unique gelling action locks in exudate and harmful bacteria and micro-contours to a simulated wound bed, minimizing “dead space” where bacteria can thrive.
AQUACEL® Ag dressings with ionic silver provide rapid, effective and sustained antimicrobial activity. As demonstrated in vitro, AQUACEL® Ag dressings kill a broad spectrum of pathogens, including methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant enterococci (VRE), within 30 minutes of exposure to the dressing, for up to seven days.
ConvaTec is a global medical products and technologies company, with leading market positions in wound therapeutics, ostomy care, continence and critical care, and infusion devices. Our products provide a range of clinical and economic benefits, including infection prevention, protection of at-risk skin, improved patient outcomes and reduced total cost of care. ConvaTec has over 8,000 employees, with 11 manufacturing sites in 8 countries, and we do business in more than 100 countries. We are owned by Nordic Capital and Avista Capital Partners. More information is available at www.convatec.com.
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References available upon request.