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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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC11843900PMC
http://dx.doi.org/10.3390/ebj6010001DOI Listing

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Objective: To assess the efficacy and safety of a carboxymethylcellulose dressing containing ionic silver, ethylenediaminetetraacetic acid and benzethonium chloride (CISEB) versus a dialkylcarbamoyl chloride-coated dressing (DACC) in hard-to-heal venous leg ulcers (VLUs).

Method: In a multinational, multicentre, randomised controlled trial, patients with hard-to-heal VLUs were randomised 1:1 to receive CISEB (n=100) or DACC (n=103) for up to four weeks. VLUs that were not healed by week 4 were managed with standard of care for up to 12 weeks or until healed (whichever was sooner).

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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.

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Background Surgical site infections (SSIs) represent a significant burden in healthcare, commonly occurring after surgical procedures and leading to prolonged recovery times and increased healthcare costs. Traditional antimicrobial dressings pose risks such as antimicrobial resistance. This study aimed to evaluate the safety and clinical efficacy of dialkyl carbamoyl chloride (DACC)-impregnated dressings, which use a purely physical mechanism to prevent bacterial contamination, in patients undergoing orthopaedic or gastrointestinal surgeries.

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Article Synopsis
  • - Reports of antimicrobial resistance have led some clinicians to use alternative wound dressings called DACC-coated dressings, claiming antimicrobial activity despite being non-medicated.
  • - A systematic review was conducted to evaluate the effectiveness of these dressings on chronic wound healing and infection control, using the GRADE framework and PICO format to structure the research.
  • - The review analyzed 748 records, ultimately including 10 relevant studies, but found the overall quality of evidence to be very low, highlighting the need for more rigorous randomized controlled trials for better clarity on DACC-coated dressings.
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