Efficacy of Dialkylcarbamoylchloride (DACC)-Impregnated Dressings in Surgical Wound Management: A Review.

IF 1.2 Q4 CRITICAL CARE MEDICINE
Madhan Jeyaraman, Naveen Jeyaraman, Swaminathan Ramasubramanian, Arulkumar Nallakumarasamy, Shrideavi Murugan, Tarun Jayakumar, Sathish Muthu
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Abstract

Surgical site infections (SSIs) are a significant challenge in postoperative care, leading to increased morbidity, extended hospital stays, and elevated healthcare costs. Traditional antimicrobial dressings, such as those containing silver or iodine, have limitations, including cytotoxicity and the potential for antimicrobial resistance. Dialkylcarbamoyl chloride (DACC)-impregnated dressings offer a novel approach, employing a physical mechanism to bind and remove bacteria without the use of chemical agents, thereby reducing the risk of resistance. This review summarizes current evidence on the efficacy of DACC dressings in preventing SSIs and promoting wound healing. Findings from multiple studies indicate that DACC dressings reduce bacterial burden and SSI rates across various surgical procedures, including cesarean sections and vascular surgeries. Additionally, DACC dressings demonstrate potential in managing hard-to-heal wounds, such as diabetic foot ulcers, by reducing bacterial load and biofilm formation. Furthermore, they present advantages in antimicrobial stewardship and cost-effectiveness by minimizing the need for antibiotics and decreasing overall healthcare expenses. However, the current literature is limited by small sample sizes, methodological weaknesses, heterogeneity in study designs, and a lack of long-term data. Future research should focus on high-quality randomized controlled trials across diverse surgical populations, comprehensive cost-effectiveness analyses, and long-term outcomes to establish the full clinical impact of DACC dressings. With further validation, DACC-impregnated dressings could become a critical tool in sustainable postoperative wound care.

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二烷基氨基甲酰氯(DACC)浸渍敷料在外科伤口处理中的疗效综述。
手术部位感染(ssi)是术后护理的一个重大挑战,导致发病率增加、住院时间延长和医疗费用增加。传统的抗菌敷料,如含银或碘的敷料,具有局限性,包括细胞毒性和潜在的抗菌素耐药性。二烷基氨基甲酰氯(DACC)浸渍敷料提供了一种新颖的方法,采用物理机制结合和去除细菌,而不使用化学试剂,从而降低了耐药性的风险。本文综述了目前关于DACC敷料在预防ssi和促进伤口愈合方面的有效性的证据。多项研究结果表明,DACC敷料可减少各种外科手术的细菌负担和SSI发生率,包括剖宫产和血管手术。此外,DACC敷料通过减少细菌负荷和生物膜的形成,在治疗难以愈合的伤口(如糖尿病足溃疡)方面显示出潜力。此外,它们通过最大限度地减少对抗生素的需求和降低总体医疗保健费用,在抗菌药物管理和成本效益方面具有优势。然而,目前的文献受到样本量小、方法学薄弱、研究设计异质性和缺乏长期数据的限制。未来的研究应集中在不同手术人群的高质量随机对照试验,综合成本效益分析和长期结果,以确定DACC敷料的全面临床影响。随着进一步的验证,dacc浸渍敷料可能成为可持续的术后伤口护理的关键工具。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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