Dressings for CABG/Valve patients

Nurses General Nursing

Published

Specializes in Cardiac surgery.

I currently work on a progressive care floor and care for post cabg and valve patients. For the past several years the surgeons having been using what is called Silverlon dressings on the sternal incisions. When researching this specific dressing, it has shown that when using the silverlon dressing for 7 days, it is able to cut sternal wound infections down by almost 50%.

I am doing some research and wanting to know what kind of dressings (if any) are being used on your open heart patients?

Francesca, RN

Specializes in Tele, Home Health, MICU, CTICU, LTC.

We do not use dressings on our CABG and valve patients after the first 12 - 24 hours, unless the incision is draining. When we do use dressings it is just gauze and tape, which also what we use on our chest tube sites for these patients.

We use an insulin infusion protocol on every cardiac surgery patient for the 48 hours post op and then all are placed on sliding scale insulin. Keeping a patients blood sugar very well controlled also decreases the rate of sternal wound infections. We have seen a significant decrease in the cases of sternal wound infections since implementing this protocol on our unit over a year ago.

I currently work on a progressive care floor and care for post cabg and valve patients. For the past several years the surgeons having been using what is called Silverlon dressings on the sternal incisions. When researching this specific dressing, it has shown that when using the silverlon dressing for 7 days, it is able to cut sternal wound infections down by almost 50%.

I am doing some research and wanting to know what kind of dressings (if any) are being used on your open heart patients?

Francesca, RN

For our fresh hearts we normally use normal island dressings for the first few days, then leave it open to air (if extubated) I am not sure about our sternal wound infection rates and If they are high I will get back to you, but that is interesting about the Silverlon dressings I will for sure have to find more information about them.

1 Votes
Specializes in Surgery, Tele, OB, Peds,ED-True Float RN.
For our fresh hearts we normally use normal island dressings for the first few days, then leave it open to air (if extubated) I am not sure about our sternal wound infection rates and If they are high I will get back to you, but that is interesting about the Silverlon dressings I will for sure have to find more information about them.

I don't work cardiac, never have... this may be a stupid question, but what is an Island Dressing??? Just like a dry dressing???

>When researching this specific dressing, it has shown that when using the silverlon dressing for 7 days, it is able to cut sternal wound infections down by almost 50%.

Sounds like someone is trying to market a product. No ne covers sternal incissions for 7 days - that went out with the ark.

Specializes in Nurse Scientist-Research.

It's been 7 years since I worked with CABG patients, and like most they didn't have sternal dressings in place once they came out of ICU. In my 9 years of caring for post-op CABG's I only remember one gentleman with a sternal wound infection. They problem always seemed to be with those leg wounds. Almost every patient seemed to have some degree of infection/inflammation on those legs by they time they went home. Many patients with previous CABG's had nasty scars on their legs.

Specializes in Cardiac surgery.

I am not trying to market anything. I am doing research for a class project. Where I work, we still use the Silverlon dressings for 7 days post op. We wash the incision daily with hibiclens, and we have to rewet the silverlon twice a day. One of the surgeons did research on the silverlon dressing and it showed to decrease the infection rate.

This particular dressing is interesting to me, that is why i am curious to see what the hospitals are using and why.

Thanks for the input everyone!

Specializes in Cardiac Telemetry, ED.

It's been a while since I worked with post OHS patients in one of the busiest OHS centers in three surrounding states, but our protocol (which I believe is still in use) is to leave the incision OTA after the first 24 hours and clean around the incision (not directly on it) with betadine, in addition to tight blood glucose control. I don't recall ever seeing a sternal wound infection. The graft harvest sites on the legs are another story. That is where I saw the most frequent postop infections. My theory was that it had to do with being "downstream" from the nether regions, so to speak.

Specializes in Telemetry, IMCU, s/p Open Heart surgery.

i've been working on an open heart unit for the past 2 years.

our current protocol has us leave the Silverlon dressing for 72 hours then we remove them and leave the incision OTA unless the wound is draining. we then have them shower and paint the incision with betadine daily.

we also have the patients on an insulin drip for the first 48 hours post op, then a low salt/cholesterol diet with no concentrated sweets. after the insulin gtt is d/c we still do accuchecks Q4 hours while sugars are 120 (with custom post-op Novolin coverage) and above and ac/hs if the sugars are below 120.

our sternal wound infection rate is low... we had an admission about 2 weeks ago and before that i dont even remember when we had one :) hope this helps.

Specializes in Cardiac surgery.

Thank you! Another question for you NurseStephRN, do you rewet the silverlon dressing with sterile water twice a day? Or do you leave the original dressing from surgery on the patient until removed pod 3? our protocol is to wash the incision with hibiclens daily, and rewet the silverlon dressing bid with sterile water. We also have the pts on a insulin drip for 48hrs, and monitor accuchecks ac/hs until their blood sugar is below 120 (the accuchecks will be d/c on non-diabetics if there is two consecutive blood glucose readings of

Thank you ALL again for your input! Greatly appreciated :)

Specializes in cardiothoracic surgery.

We clean and redress our sternal incisions after 24 hours and then leave them OTA at 48 hours. Our rate of sternal wound infections is fairly low. We also use on insulin gtt protocol for blood sugars. I think since we have started being more strict with this, our sternal rate infection has decreased. Before we started the tight glycemic control, I remember some pretty nasty sternal wound infections, haven't seen one of those forever. As far as the leg incisions, I don't remember seeing one of those infected in a post-CABG. We usually see groin incision infections from fem-pop's or EVAR's.

Specializes in Telemetry, IMCU, s/p Open Heart surgery.

hey there...

we don't rewet the dressing at all. i've never heard of that. the dressing that we take off is the same dressing the surgeon put on after the surgery. after we remove the dressing we do the betadine daily and make them shower, and of course the glycemic control. for non-diabetics we get the accuchecks d/c if we don't have to cover them for 24 hours.

+ Add a Comment