by Francesca RN

I have a question for you guys. I am doing a project on sternal dressings. I work on a step down unit, where I receive OH patients POD 1. We are using Silverlon dressings on the sternal incisions, and these dressings are to be worn for 7 days post op. We wash the incisions daily with hibiclens, and the silverlon dressing is to be wet with sterile water twice a day. One of the surgeons did research on this product and it showed to cut the infection rate by 50%. The silverlon dressing to me are interesting. I posted a message on the general nursing forum, and got some replies saying that after the first day post op, the incisions are kept OTA. What dressings (if any) are being used on your OH patients?

Thanks for your input,
Francesca

Re: dressing changes for OH patients

We leave them OTA POD1-2, sometimes we betadine them after taking the dressing down, but usually we don't do a lot with them. If they get infected or don't heal well for whatever reason we may use some sort of packing, but that's pretty uncommon.

Re: dressing changes for OH patients

Open to air starting POD#2; the incision is epithelialized by then.

Postop wound infection is directly related to intraop technique and good closure, nutrition, adherent sternal prec etc.

Do you have data on these dressings?

Re: dressing changes for OH patients

One of the surgeons I know did research on these types of dressings that we use. I am doing a project, and thought it would be interesting to see what others are using with the OH patients. If you would like, I could find the research he did and post it.

Re: dressing changes for OH patients

You take the silverlon down to wash the incision with CHG? Why?? The silverlon itself is bactericidal. You really only need to re-wet when it dries out. Secondary dressing depends on how much the wound is exudating.

I am not a huge fan of silver dressings as they have been proven to be keratinotoxic and can impair healing and macrophage function.

The dressing I don't think has a huge impact on sternal wound infections - as mentioned, it's generally an issue of excessive bleeding, surgical technique, nutrition state, etc. I would want to focus on those things instead of the sternal dressing if you have high infection rates.

We did a comparative study between plain primapore and other dressings at my last hospital - really didn't make enough of a difference to justify the cost of the silver dressings.

Re: dressing changes for OH patients

Thank you all for your input. I am doing a project for one of my classes and you all have been a great help!
Thanks,
Francesca

Re: dressing changes for OH patients

PS: If you want a great antibacterial dressing that also has excellent healing properties, try MediHoney!