Aquacel® Surgical Dressing Reduces the Rate of Acute PJI Following Total Joint Arthroplasty: A Case-Control Study

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Authors: Cai J, Karam JA, Parvizi, J, Smith E.B, Sharkey, P.F.
The Rothman Institute at Thomas Jefferson University Hospital, Philadelphia, PA

Title: Aquacel® Surgical Dressing Reduces the Rate of Acute PJI Following Total Joint Arthroplasty: A Case-Control Study

Background: Periprosthetic joint infection (PJI) remains a challenging complication after total joint arthroplasty (TJA). Wound drainage and superficial infection represent a significant postsurgical risk factor for PJI. An effort to prevent PJI has led to development of dressings with features that support wound healing and contain antimicrobial agents.

Hypothesis/Purpose: We sought to determine whether the commercially available Aquacel® Surgical dressing independently reduces the rate of acute PJI following TJA.

Methods: A single institution retrospective chart review of 903 consecutive cases who received the Aquacel® Surgical dressing and 875 consecutive cases who received standard gauze dressing was conducted. The incidence of acute PJI (occurring within 3 months) was determined in both cohorts. Collected data was subjected to multivariate analysis to determine if the use Aquacel® dressing was an independent factor for reduction of acute PJI.

Results: Acute PJI occurred in 0.44% of patients who received the Aquacel® dressing compared to 1.7% of patients who received the standard gauze dressing (p=0.005).

Discussion: The multivariate analysis revealed that the use of Aquacel® dressing was an independent risk factor for reduction of PJI (odds ratio of 0.165, 95% confidence interval: 0.051-0.533). Six out of 37 factors examined, namely age, body mass index, smoking status, thyroid disease, liver disease and history of steroid treatment, were associated with PJI.

Conclusion: The Aquacel® Ag Hydrofiber wound dressing with ionic silver appears to significantly reduce the incidence of acute PJI following elective arthroplasty.