ArticleArchives of orthopaedic and trauma surgery2026
Silver-impregnated occlusive dressing is associated with a lower rate of acute surgical site infection after direct anterior total hip arthroplasty.
Article in Archives of orthopaedic and trauma surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
introductionThe direct anterior approach (DAA) for total hip arthroplasty (THA) has gained increasing adoption in recent years; however, it has been associated with a higher risk of wound-related complications compared with other surgical approaches. Silver-impregnated occlusive dressings have demonstrated antimicrobial potential, though their role in DAA THA remains underexplored. MATERIALS AND
methodsWe conducted a retrospective cohort study with a historical control group, reviewing 321 consecutive primary DAA THAs performed by a single surgeon (September 2020-December 2025). Standard sterile gauze was used before August 2021 (n = 76) and a silver-impregnated occlusive dressing (AQUACEL
resultsFour acute SSI events occurred (1.25%). SSI incidence was 3.94% (3/76) with gauze versus 0.41% (1/245) with the silver-impregnated dressing (Fisher's exact p = 0.043). This corresponds to an absolute risk reduction (ARR) of 3.54% (95% CI, 0.34-10.57) and a number needed to treat (NNT) of 29 (95% CI, 10-293). No deep PJI occurred. Given sparse events, adjusted analyses were considered exploratory; in a penalized (Firth) logistic model, silver dressing remained associated with lower odds of SSI, while higher BMI and diabetes were associated with higher odds.
conclusionsIn this retrospective historical-control cohort, silver-impregnated occlusive dressing use was associated with a lower 30-day SSI rate after DAA THA. Given the low event rate and potential temporal confounding, these findings should be interpreted cautiously and warrant confirmation in larger studies.
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