Dialkylcarbamoyl chloride-impregnated dressing for the prevention of surgical site infection in women undergoing cesarean section: A pilot study

Abstract

Introduction: Incisional surgical site infections (SSIs) occur in approximately 1.8-9.2% of patients subject to a cesarean section (CS) and contribute to prolonged hospitalization time and increased treatment costs. Dressings impregnated with dialkylcarbamoyl chloride (DACC) are an innovative approach to wound treatment based on a solely physical mechanism of action, and therefore can be used safely and without time restrictions in women during the puerperal and lactation period. Material and methods: A single-blinded randomized, controlled pilot study was conducted at the Mazovian Bródno Hospital, a tertiary care hospital, between December 2013 and March 2014, and it evaluated the presence of superficial and deep SSIs in patients during the first 14 days after a CS. Patients were randomly allocated to receive treatment with either a DACC dressing or a standard surgical dressing. Results: One hundred and forty-two patients after planned or emergency CS were enrolled in the study. No significant differences between the groups were observed with regard to patients' basic demographic and perioperative characteristics. The rate of superficial and deep SSIs was 2.8% in the group of patients who received a DACC dressing compared to 9.8% in the group with a standard surgical dressing (p = 0.08). Patients with SSIs who received a standard surgical dressing required systemic antibiotic therapy significantly more frequently (p = 0.03). Based on the logistic regression model developed, the pre-pregnancy body mass index was the only statistically significant risk factor for SSI (p = 0.015). Conclusions: The results of the pilot study indicate a decreasing tendency of the SSI rate in patients after a CS who received DACC dressings.