Focus on antimicrobial dressings

Surgical site infections (SSIs) continue to be a major cause of morbidity and mortality, despite advances in infection control practices.

The risk of SSI is approximately 1% - 3% for elective clean surgery. The risk increases in contaminated surgery, ranging from around 19% to 23%. While most SSIs are thought to be acquired at the time of surgery, there is no data on the actual numbers in this setting versus those acquired during postoperative care. SSI can prolong hospital stays as well as increase expenditure for patients, providers and hospitals.

Over the last 20 to 30 years wound management has undergone major changes. With the introduction of epidermal growth factors and the recognition that moist wound healing is preferable to the dry dressing technique, there has been an exponential growth in the development of new wound dressings.Of growing interest are antimicrobial dressings (AMDs).

Advantages of AMDs
Resistance to oral antibiotics continues to escalate, with clinicians now looking to alternative methods for treating wound infections. AMDs that offer a broad spectrum of activity allow clinicians the opportunity to fight antibiotic-sensitive and resistant wound pathogens. By inhibiting the growth of pathogens, AMDs offer substantial benefits to both patients and hospitals by reducing the spread of resistant organisms and reducing costs associated with wound infections. By promoting rapid healing with fewer complications AMDs can reduce costs such as antibiotic treatment or extended hospitalisation.

Other advantages include:
• Only the wound and immediate tissues are exposed
• Higher levels of the antibacterial are achieved
• Limits toxicity and tissue reaction
• May be multifunctional (eg, reduce odour and exudate as well as infection)

Features of an ideal AMD
Features of an ideal AMD include:
• Sustained antimicrobial activity
• Provision of a moist wound-healing environment
• Consistent delivery of the antimicrobial over the entire surface of the wound
• Allows monitoring of the wound with minimum interference
• Comfort
• Effective microbial barrier
• Absorbs and retains bacteria
• Avoids trauma on removal