Infection of the wound or surgical site is always a concern for nurses taking care of patients post-operatively, so any practice that can be improved to help prevent such infections should be studied with care. Silver-infused dressings and ointments are a contender because silver has natural antibacterial properties, and has the potential to decrease the risk of surgical site infections (SSI). “When silver dressings come in contact with exudates, silver (an antibacterial and antifungal) is released. Although expensive, these dressings are effective and are useful as a supplement to systemic therapies, which may have difficulty reaching therapeutic levels in the wound bed (especially for patients with poor vascular perfusion)” (Bennett-Marsden, 2010). Some of the areas that silver-impregnated dressings or ointments containing silver may be used in patients with total knee or total hip arthroplasty, colorectal surgery, and for burn patients.

QUESTION

Infection of the wound or surgical site is always a concern for nurses taking care of patients post-operatively, so any practice that can be improved to help prevent such infections should be studied with care. Silver-infused dressings and ointments are a contender because silver has natural antibacterial properties, and has the potential to decrease the risk of surgical site infections (SSI). “When silver dressings come in contact with exudates, silver (an antibacterial and antifungal) is released. Although expensive, these dressings are effective and are useful as a supplement to systemic therapies, which may have difficulty reaching therapeutic levels in the wound bed (especially for patients with poor vascular perfusion)” (Bennett-Marsden, 2010). Some of the areas that silver-impregnated dressings or ointments containing silver may be used in patients with total knee or total hip arthroplasty, colorectal surgery, and for burn patients.

For nurses, having a decreased risk of infection when their patients come back from a surgical procedure would assist in several elements of the patient’s stay. With a decreased risk of infection, the patient has the opportunity to physically feel better faster, they will have the opportunity to start physical therapy with greater ease (decreased pain, decreased fear), and have the chance of having a shorter overall hospital stay. With some of the silver-impregnated occlusive dressings, they are waterproof and do not get removed for a week following surgery. This should theoretically allow the patient to shower or bathe in their normal fashion sooner, and also spare the nurse’s time in giving a bath in bed or changing the dressing.

PICOT Question: In arthroplasty patients, will silver infused ointments or dressings as compared to non-silver infused ointments or dressings decrease rates of infection when applied after surgery?

P: In arthroplasty patients,

I: will silver infused ointments or dressings

C: as compared to non-silver infused ointments or dressings

O: decrease rates of infections

T: when applied after surgery?

ANSWER

The Effectiveness of Silver-Infused Dressings and Ointments in Reducing Infections in Arthroplasty Patients

Introduction

Infection prevention is a critical concern for nurses caring for patients after surgical procedures. Surgical site infections (SSIs) can significantly impact patient outcomes, prolong hospital stays, and increase healthcare costs. To mitigate this risk, various strategies are explored, one of which is the use of silver-infused dressings and ointments. Silver, known for its natural antibacterial properties, has the potential to reduce the incidence of SSIs by releasing antimicrobial agents when in contact with wound exudates. This essay aims to examine whether silver-infused dressings or ointments, when compared to non-silver-infused alternatives, can effectively decrease infection rates in arthroplasty patients.

PICOT Question

In arthroplasty patients, will silver-infused ointments or dressings, compared to non-silver-infused ointments or dressings, decrease rates of infection when applied after surgery?

Methods

To address the PICOT question, a systematic review and meta-analysis of relevant studies will be conducted. The search will include electronic databases, such as PubMed and Cochrane Library, using appropriate keywords and MeSH terms (Eriksen & Frandsen, 2018). Studies published within the last ten years will be considered, ensuring the inclusion of the most recent evidence. Randomized controlled trials (RCTs), prospective cohort studies, and comparative studies will be included, while case reports, editorials, and conference abstracts will be excluded (Grewal et al., 2016).

Results

The selected studies will be critically appraised for methodological quality and risk of bias using established tools, such as the Cochrane Collaboration’s Risk of Bias tool for RCTs and the Newcastle-Ottawa Scale for cohort studies (Ma et al., 2020). Data from eligible studies will be extracted and synthesized to determine the overall effect of silver-infused dressings or ointments on infection rates in arthroplasty patients. Statistical analysis, such as meta-analysis, will be performed if appropriate.

Discussion

Based on the available evidence, the discussion will analyze the effectiveness of silver-infused dressings and ointments in reducing infection rates in arthroplasty patients. The findings will be interpreted in the context of study design, patient population, and intervention characteristics. Potential mechanisms underlying the antimicrobial properties of silver will be explored, providing insights into its mode of action. The implications for clinical practice will be discussed, considering factors such as cost-effectiveness, ease of application, and patient comfort.

Conclusion

This essay aims to examine the impact of silver-infused dressings and ointments on infection rates in arthroplasty patients. By reviewing the existing evidence and conducting a comprehensive analysis, we can draw conclusions regarding the effectiveness of silver-infused interventions in reducing SSIs. The findings will provide valuable insights for nurses and healthcare professionals involved in post-operative care, potentially leading to improved patient outcomes, shorter hospital stays, and enhanced overall patient satisfaction.

References

Eriksen, M. B., & Frandsen, T. F. (2018). The impact of patient, intervention, comparison, outcome (PICO) as a search strategy tool on literature search quality: a systematic review. The Impact of Patient, Intervention, Comparison, Outcome (PICO) as a Search Strategy Tool on Literature Search Quality: A Systematic Review, 106(4). https://doi.org/10.5195/jmla.2018.345 

Grewal, A., Kataria, H., & Dhawan, I. (2016). Literature search for research planning and identification of research problem. Indian Journal of Anaesthesia, 60(9), 635. https://doi.org/10.4103/0019-5049.190618 

Ma, L., Wang, Y., Yang, Z., Huang, D., Weng, H., & Zeng, X. (2020). Methodological quality (risk of bias) assessment tools for primary and secondary medical studies: what are they and which is better? Military Medical Research, 7(1). https://doi.org/10.1186/s40779-020-00238-8