“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.”
The case-control study of primary TKR and THR surgery compared the incidence of superficial and deep PJI in patients who received a silver nylon dressing (Silverlon—the study group) with patients who received a standard dressing (Xeroform and gauze—the control group). The study included a total of 834 patients with 309 consecutive total joint replacement (TJR) cases in the study group and 525 consecutive TJR cases in the control group. The same two surgeons performed all surgeries and study patients were followed for twelve months to identify PJI. Infection data in the control group were extracted retrospectively based on chart review.
Study findings included:
The incidence of infection was significantly lower (p = 0.012) in the Silverlon study group (3.9 percent) compared with the control group (8.4 percent). This result represents a 54 percent reduction in the rate of infection with Silverlon use.
No deep PJIs occurred in the Silverlon study group; there were 12 deep PJIs (2.3 percent) in the control group.
Odds of any infection were significantly less in the Silverlon study group compared with the control group (OR, 0.382; 95 percent CI, 0.250-0.583; P < 0.0001)
No adverse reactions to the silver dressing were reported.
As the number of joint replacements performed in the U.S. continues to rise, so does the number of patients affected by prosthetic joint infection. PJI is the most common cause of failure of total knee replacement (TKR) surgery and the third most common cause of failure following total hip replacement (THR) surgery. According to the study publication, total joint replacement procedures in the U.S. have resulted in 5,310 to 21,240 infections per year, and the financial impact of PJI in the U.S. was $566 million in 2009 and is projected to increase to $1.62 billion in 2020.
“Silverlon has been included in numerous studies that have demonstrated that silver-nylon dressings can offer advantages over standard gauze, helping to improve patient care,” said Raul Brizuela, president and CEO of Argentum Medical. “We are pleased the additional data from Harvard’s independent research help demonstrate the benefits of Silverlon in the protection of surgical wounds to improve outcomes for orthopaedic patients.”
“Other studies have demonstrated the effectiveness of silver-nylon dressings in cardiothoracic, colorectal and lumbar-spine surgery. Adding the present study to what we already know, use of silver-nylon dressings should help improve the standard of care for joint replacement and other orthopedic surgery procedures,” added Dr. Barillo.