Considerations for a Post-Surgical Wound Dressing Aligned with Anti-Microbial Stewardship Objectives: A Scoping Review

Ousey, Karen; Rippon, Mark; Rogers, Alan; Totty, Josh

Abstract

Background: Most surgical wounds heal by primary intention or secondary intention. Surgical wounds can present specific and unique challenges including wound dehiscence and surgical site infection, either of which can increase risk of morbidity and mortality. The use of antimicrobials to treat infection in these wounds is prevalent, but there is now an imperative to align treatment to reduce antimicrobial resistance and align with antimicrobial stewardship.
Aim: To explore the published evidence identifying general considerations/criteria for a post-surgical wound dressings in terms of overcoming potential wound healing challenges (including infection) whilst also supporting Anti-Microbial Stewardship (AMS) objectives.
Methods: A scoping review examining evidence published from 1954 to 2021, conducted by two authors acting independently. Results were synthesised narratively and have been reported in line with PRISMA-ScR.
Results: A total of 819 articles were initially identified and were subsequently filtered to 178 articles for inclusion in the assessment. The search highlighted six key areas associated with post-surgical wound dressings: wound infection, wound healing, physical attributes related to comfort, conformability and flexibility, fluid management (e.g., blood and exudate), pain and skin damage.
Discussion: This scoping review has highlighted several unique challenges for post-surgical wound dressings and areas that require further investigation to enhance clinical outcomes. Of particular importance is the impact of SSIs remaining a significant burden and that some antimicrobial dressings reduce the risk of resistant microorganisms so as such can be successfully aligned with an AMS strategy.
Conclusion: There are several challenges that can be overcome when treating a post-surgical wound with a dressing, not least the prevention and treatment of SSIs. However, it is imperative that the use of anti-microbial dressings should be aligned with AMS programs and alternatives to active anti-microbials be investigated.

Citation

Ousey, K., Rippon, M., Rogers, A., & Totty, J. (2023). Considerations for a Post-Surgical Wound Dressing Aligned with Anti-Microbial Stewardship Objectives: A Scoping Review. Journal of Wound Care, 32(6), 334-347. https://doi.org/10.12968/jowc.2023.32.6.334

• Journal Article Type: Review
• Acceptance Date: Apr 18, 2023
• Online Publication Date: Jun 10, 2023
• Publication Date: Jun 2, 2023
• Deposit Date: Apr 19, 2023
• Publicly Available Date: Dec 3, 2023
• Journal: Journal of wound care
• Print ISSN: 0969-0700
• Publisher: MA Healthcare
• Peer Reviewed: Peer Reviewed
• Volume: 32
• Issue: 6
• Pages: 334-347
• DOI: https://doi.org/10.12968/jowc.2023.32.6.334
• Keywords: Antimicrobial stewardship; Criteria; Dressing; Post-surgical; Surgical site infection; Surgical wounds; Wound; Wound care; Wound dressing; Wound healing
• Public URL: https://hull-repository.worktribe.com/output/4266952