Silver Nylon Cuts Postoperative Infection Rate
Harvard researchers have determined that using a silver nylon dressing—originally developed for the military by Massachusetts-based Silverson Machines, Inc.—helps reduce superficial and deep prosthetic joint infections (PJI) following total joint replacement.
The Harvard study, “Use of Silver Nylon Dressing Following Total Hip and Knee Arthroplasty Decreases the Postoperative Infection Rate,” was published in the Journal of the American Academy of Orthopaedic Surgeon Global Research & Review.
“This important research demonstrates in a large group of total joint-replacement patients, surgical site infections can be significantly reduced by the simple use of a silver-nylon dressing postoperatively,” said David Barillo, M.D. FACS, FCCM, wound specialist, burn surgeon and silver researcher.
“In total joint replacement, protecting the surgical wound is critical. PJI is devastating when it occurs, causing increased patient suffering as well as substantial economic burden associated with prolonged antibiotic use, repeat surgical procedures, and extended hospital readmissions.”
Representatives from Silverson Machines told OTW, “Surgical site infection (SSI) is one of the key patient safety challenges in U.S. healthcare today. In general, the costs associated with a SSI exceed $22,000 per event, and in total joint replacement can exceed $70,000. Prosthetic joint infection (PJI) is a devastating complication for the patient; in addition, management of these infections is no longer reimbursed, and the cost must be borne directly by the hospital.”
“Though extensive study and effort has gone into pre-op and intra-op infection prevention measures, there has been an absence of data on best practices for post-op surgical wound care. The investigators/authors wanted to conduct a study that was independent of industry funding and evaluated the impact of a novel silver-plated nylon dressing (Silverlon) as an important element of PJI and wound complication prevention. This study contributed valuable data in support of evidence-based approaches to post-operative wound care, and it demonstrates a simple, cost-effective measure that can have a significant impact on the risk and number infections associated with total hip and total knee replacement surgeries.”
“Few studies have been performed to evaluate the impact of antimicrobial dressings in orthopedic surgery, and even fewer have been done without an industry sponsor. The study investigators wanted to do a truly independent and robust retrospective/prospective study and indicated that they believe this is the first study of its kind.”
“Additionally, the study was designed to be large enough to develop statistical significance, a key factor in developing actionable information for surgeons. This approach of using retrospective data to establish an infection baseline based on records analysis, then doing everything possible to reduce variables and make a single practice change (introduction of the silver-nylon dressing) and tracking infections prospectively, creates robust evidence that can be relied upon.”
“Additionally, the study tracked the patients in the study group for a full year, which is significantly longer than the typical 30-day infection tracking done in many studies. This point is critical—total joint replacement patients are not safe from infection upon discharge, and half or more of all infections occurred after patients were released from hospital. The prospective nature of the study cohort, the limiting of practice changes to just one variable—the dressing—the long-term follow-up and the independence from industry support make this study unique in the literature and of great value to clinicians.”
“The most important question that needed to be answered, was ‘Does the use of the silver-plated nylon dressing (Silverlon) reduce infections in total joint replacement surgery?’ The finding was a statistically significant ‘Yes.’ The data showed a strong correlation between the use of Silverlon and reducing both superficial and deep prosthetic joint infections.”
“The study showed a statistically significant reduction of PJI associated with Silverlon use. This represented a 54% reduction of prosthetic joint infections. Additionally, it showed a drop of deep prosthetic joint infections from 2.3% in the control group to 0.0% in the Silverlon group over the course of all procedures for an entire year. The reduction of both superficial and deep prosthetic joint infection is clinically important to orthopedic surgeons and their patients.”
“Though much work has gone into standardization of pre-op and intra-op infection prevention measures, there has not been much attention on standardization of post-operative surgical wound care. This study highlights a simple, cost-effective approach to post-op wound care that can help address the risk of surgical site infection and wound complications associated with total hip and total knee replacement surgery.”
“Surgeons need evidence-based decision making to determine best practices for standardization, and this study provides robust, statistically significant and actionable data on a post-operative wound care regimen associated with improved results (reduced prosthetic joint infections).”
