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(Chest. 2004;125:43-49.)
© 2004 American College of Chest Physicians

Effect of Three Wound Dressings on Infection, Healing Comfort, and Cost in Patients With Sternotomy Wounds*

A Randomized Trial

Rochelle Wynne, RN, MEd; Mari Botti, RN, PhD; Hilary Stedman, RN; Lynda Holsworth, RN, BN (Hons); Maria Harinos, RN, BN; Olivia Flavell, RN, BN and Christianne Manterfield, RN, BN

* From the School of Nursing (Ms. Wynne and Dr. Botti), Deakin University, Burwood; and the Cardiothoracic Unit (Ms. Stedman, Ms. Harinos, and Ms. Flavell) and Department of Respiratory Medicine (Ms. Holsworth and Ms. Manterfield), The Alfred Hospital, Prahran, Australia.

Correspondence to: Rochelle Wynne, RN, MEd, School of Nursing, Deakin University, 221 Burwood Highway, Burwood, VIC, Australia 3125; e-mail: rwynne{at}deakin.edu.au

Study objective: To compare three dressing types in terms of their ability to protect against infection and promote healing, patient comfort, and cost-effectiveness.

Design: Prospective, randomized controlled trial.

Setting: Major metropolitan, academically affiliated, tertiary referral center.

Patients: Seven hundred thirty-seven patients were randomized to receive a dry absorbent dressing (n = 243) [Primapore; Smith & Nephew; Sydney, NSW, Australia], a hydrocolloid dressing (n = 267) [Duoderm Thin ConvaTec; Mulgrave, VIC, Australia], or a hydroactive dressing (n = 227) [Opsite; Smith & Nephew] in the operating theater on skin closure.

Results: There was no difference in the rate of wound infection or wound healing between treatment groups. The Primapore dressing was the most comfortable and cost-effective dressing option for the sternotomy wound. Duoderm Thin dressings were associated with increased wound exudate (p < 0.001), poor dressing integrity (p < 0.001), more frequent dressing changes (p < 0.001), more discomfort with removal (p < 0.05), and increased cost (p < 0.001).

Conclusions: In the context of no additional benefit for the prevention of wound infection or the rate of wound healing for any of the three dressing products examined, dry absorbent dressings are the most comfortable and cost-effective products for sternotomy wounds following cardiac surgery.

Key Words: cardiac surgery • sternotomy incision • wound dressing






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