The effect of incisional plastic drapes and redisinfection of operation site on wound infection following caesarean section. Do plastic adhesive drapes prevent post caesarean wound infection? Development of a safe and effective one-minute preoperative skin preparation. Plastic adhesive drapes and wound infection after hip fracture surgery. The role of plastic wound drapes in the prevention of wound infection following abdominal surgery. The value of a plastic adhesive drape in the prevention of wound infection. A controlled trial. [Transparent adhesive tape as postoperative dressing. Randomized, clinical study for comparison with a conventional dressing technic].
In a randomized prospective multicentre study of post-caesarean wound infection among 1,340 women in eight hospitals, the effect of redisinfection of the skin around the incision before skin closure and the effect of adhesive skin drapes were investigated. The overall rate of wound infection with pus was 5.0% (range 3.5-8.9%). The study showed a reduction in postoperative wound infection associated with redisinfection (P = 5.5%), while no benefit from adhesive plastic drapes could be demonstrated. We conducted a prospective randomized controlled double-blind trial at a regional referral centre for the Eastern Cape area, (Livingstone Hospital) to determine whether the use of plastic adhesive drapes intraoperatively would prevent Post Caesarean Section Wound Infection. A total of 620 patients undergoing Caesarean section (CS) were enrolled for randomization in the trial. Fifteen patients were excluded, while 305 received drapes (test group) and 300 did not (control group). Two patients in the control group were subsequently excluded. The primary outcome measure was the presence of Post Caesarean Wound Infection. A secondary outcome measure was the number of days in hospital post operation. The study and control groups were comparable at entry. Results show that 34 patients in the test group (N= 305) developed wound sepsis (11.1%) compared with 30 in the control group (N= 298) (10.1%) (difference not significant; Fisher's exact test 0.6933). Average days spent in hospital postoperatively were similar for both test (infected cases: mean 10.56 SD 3.84; non-infected cases: mean 5.21 SD 1.3) and control groups (infected cases: mean 10.18 SD 3.81; non-infected cases: mean 5.2 SD 0.93) (NS). We concluded that the use of plastic adhesive skin drapes did not avert PCWS or decrease the length of post operative stay in hospital for septic cases.
                Copyright 2001 The Hospital Infection Society. Three consecutive controlled randomized clinical trials utilizing 1,324 patients were conducted to study the efficacy of incise drapes to prevent wound infections. When a polyester antimicrobial incise drape (loban 2 Antimicrobial Film) was applied to an operative area after a one-minute skin preparation using either 70% alcohol or 2% iodine in 90% alcohol, the clean wound infection rate (1.3%) and overall wound infection rate (2.5%) were comparable to those following a standard ten-minute skin preparation with Betadine (1.3% and 2.3%, respectively). During preliminary studies, it was demonstrated that separation of polyethylene antimicrobial incise drapes from the skin during operation was associated with a sixfold increase in infection rate when compared with operations in which the incise drape did not lift. Design of the drape and technique of application are important considerations in preventing lift from the skin. One hundred and twenty patients with acute hip fractures treated operatively were randomized into two groups. In the 'drape' group (n = 65) the operation site was covered with plastic adhesive drape after preparation. In the 'no drape' group (n = 55) the operation site was left uncovered. The two groups were otherwise matched. Swabs for culture were taken from skin adjacent to the wound before closure. The drape group had four positive wound swabs. There was only one positive wound swab for the no-drape group. There was no difference in the post-operative wound infection rates. A randomized controlled trial has been performed to assess the value of plastic wound drapes in the prevention of surgical wound infection. One hundred and forty-four patients undergoing abdominal surgery were allocated to one of three groups; a control group (A) in which standard cloth towels were applied to the abdominal wound, group B in which an adhesive plastic drape was added and group C in which a plastic ring protector was inserted into the wound. There were 26 cases (18 per cent) of wound infection. The wound infection rate in the plastic drape groups did not differ significantly from that in the control group. Bacteriological culture from a wound swab taken at operation was positive in 32 per cent of the cases. The presence of a plastic wound drape did not influence the positive culture rate. In 68 per cent of wounds which became infected the operative swab was positive as compared with 24 per cent in those not developing a wound infection. Thirteen of the 33 patients (39 per cent) with a positive wound swab subsequently developed a wound infection. In 10 of these 13 cases of infection the operative swab permitted an accurate prediction of the organism responsible for the subsequent infection. nan To evaluate the effect of a thin, transparent, adhesive and elastic polyurethane drape permeable only to gas and water vapor molecules but not to bacteria in comparison to a conventional drape for postoperative dressings, a randomized trial was conducted in 90 male and female patients. 44 patients had the transparent adhesive drape and 46 a conventional dressing. Both groups were reasonably well matched according to age, sex, height, weight and type of operation. There was no difference in healing of skin wounds. But reddening around the stitches was seen more often in patients with the conventional dressing than in those with the polyurethane drape (p less than 0.05). Surprisingly, most of the patients with the transparent drape (42 of 44) accepted it. The transparent adhesive drape was found to be much less expensive than the conventional dressing.
There was no evidence from the seven trials that plastic adhesive drapes reduce surgical site infection rates, and some evidence that they increase infection rates. Further trials may be justified, using blinded outcome assessment to examine the effect of adhesive drapes on surgical site infection, based on different wound classifications.