Influence of Adhesive Incise Drape Use on Surgical Site Infection Rates in Contaminated and Dirty Abdominal Operations

A. A. Adeleke, O. Olasehinde, A. O. Adisa

Abstract

BACKGROUND: Surgical Site Infection (SSI) remains the most
common cause of Healthcare Associated Infections (HCAIs). In
particular, contaminated and dirty abdominal wounds are attended by
a high rate of SSI which in turn is associated with a huge burden on
patients, caregivers and the entire health care system.

OBJECTIVE: To compare SSI rates following the use of iodine
impregnated adhesive incise drapes (Ioban) with routine conventional
drapes in contaminated and dirty abdominal surgical wounds in a
Nigerian tertiary hospital.

METHODOLOGY: Consecutive, consenting adult patients who
underwent laparotomy for cases classified as contaminated and dirty
were prospectively enrolled into the study. Patients in the investigation
arm had in addition to conventional drapes, iodine impregnated
adhesive incise drapes (Ioban) applied on the skin of the abdomen
through which incisions were made, while patients in the control arm
only had routine conventional drapes applied. All patients were
followed up to 30 days after operation. Surgical site infection rates were
compared between the two groups.

RESULTS: Sixty-two consecutive patients were enrolled into this
study, of which 55 completed the 30 days follow-up. The mean ages of
patients in the two groups were 37.96 ± 19.59 years and 36.74 ± 16.93
year (p=0.81). Males were 36 (65.5%) and females were 19 (34.5%).
Overall, 30 (54.5%) patients had surgical site infection (SSI) in this
study. Thirteen (46.4%) patients had SSI in iodine impregnated
adhesive incise drape group while 17 (63%) patients had SSI in the
conventional drape group, a difference that was not statistically
significant (p=0.22). The most commonly isolated organism from
infected wounds was Klebsiella species.

CONCLUSION: The use of iodine-impregnated surgical incise drape
was associated with a lower, though non-statistically significant SSI
rates compared to the use of conventional drapes. This marginal
benefit will require a larger population study to examine its potential
cost-effectiveness in our setting. WAJM 2024; 41 (1): 42 - 48.

KEYWORDS: Contaminated and dirty wounds, Adhesive incise
drape, Surgical Site Infection (SSI)