Mr Josh Totty J.Totty@hull.ac.uk
NIHR Clinical Lecturer in Plastic Surgery
Mr Josh Totty J.Totty@hull.ac.uk
NIHR Clinical Lecturer in Plastic Surgery
Louise H. Hitchman
Paris L. Cai
Tom Wallace
Amy E. Harwood
Professor Daniel Carradice D.Carradice@hull.ac.uk
Senior Lecturer in Vascular and Endovascular Surgery
Mr George Smith George.Smith@hull.ac.uk
Senior Lecturer
Professor Ian Chetter I.Chetter@hull.ac.uk
Professor of Vascular Surgery
A surgical site infection (SSI) may occur in up to 30% of procedures and results in significant morbidity and mortality. We aimed to assess the feasibility of conducting a randomised controlled trial (RCT) examining the use of dialkylcarbamoylchloride (DACC)-impregnated dressings, which bind bacteria at the wound bed, in the prevention of SSI in primarily closed incisional wounds. This pilot RCT recruited patients undergoing clean or clean-contaminated vascular surgery. Participants were randomised intraoperatively on a 1:1 basis to either a DACC-coated dressing or a control dressing. Outcomes were divided into feasibility and clinical outcomes. The primary clinical outcome was SSI at 30 days (assessed using Centers for Disease Control criteria and Additional treatment, Serous discharge, Erythema, Purulent exudate, Separation of the deep tissues, Isolation of bacteria and duration of inpatient Stay scoring methods). This study recruited 144 patients in 12 months at a median rate of 10 per month. Eligibility was 73% and recruitment 60%. At 30 days, there was a 36.9% relative risk reduction in the DACC-coated arm (16.22% versus 25.71%, odds ratio 0.559, P = 0.161). The number needed to treat was 11 patients. A large-scale RCT is both achievable and desirable given the relative risk reduction shown in this study. Further work is needed to improve the study protocol and involve more centres in a full-scale RCT.
Totty, J. P., Hitchman, L. H., Cai, P. L., Wallace, T., Harwood, A. E., Carradice, D., Smith, G. E., & Chetter, I. C. (2019). A pilot feasibility randomised clinical trial comparing dialkylcarbamoylchloride-coated dressings versus standard care for the primary prevention of surgical site infection. International wound journal, 16(4), 883-890. https://doi.org/10.1111/iwj.13113
Journal Article Type | Article |
---|---|
Acceptance Date | Feb 26, 2019 |
Online Publication Date | Mar 14, 2019 |
Publication Date | Aug 1, 2019 |
Deposit Date | Sep 14, 2021 |
Publicly Available Date | Sep 24, 2021 |
Journal | International Wound Journal |
Print ISSN | 1742-4801 |
Publisher | Wiley |
Peer Reviewed | Peer Reviewed |
Volume | 16 |
Issue | 4 |
Pages | 883-890 |
DOI | https://doi.org/10.1111/iwj.13113 |
Keywords | Dialkycarbamoylchloride; RCT; Surgical site; Infection wound dressings |
Public URL | https://hull-repository.worktribe.com/output/1386745 |
Published article
(1.3 Mb)
PDF
Copyright Statement
© 2019 The Authors. International Wound Journal published by Medicalhelplines.com Inc and John Wiley & Sons Ltd.
This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
About Repository@Hull
Administrator e-mail: repository@hull.ac.uk
This application uses the following open-source libraries:
Apache License Version 2.0 (http://www.apache.org/licenses/)
Apache License Version 2.0 (http://www.apache.org/licenses/)
SIL OFL 1.1 (http://scripts.sil.org/OFL)
MIT License (http://opensource.org/licenses/mit-license.html)
CC BY 3.0 ( http://creativecommons.org/licenses/by/3.0/)
Powered by Worktribe © 2025
Advanced Search