Authors (including presenting author) :
Lok Alan(1), Ma CK(1), Chow KY(1), Ho KL(1), Tang YS(1), Ho Ivan(1)
Affiliation :
(1)Department of Orthopaedics & Traumatology, Caritas Medical Centre
Keyword 1: :
Surgical site infection
Keyword 2: :
Hip fracture
Keyword 3: :
Silver-containing dressing
Introduction :
Surgical site infection (SSI) is a major complication after hip fracture surgery, leading to delayed wound healing, prolonged hospitalization, re-operation, and, in severe cases, sepsis. At Caritas Medical Centre (CMC), the SSI rate for hip fracture cases was approximately 6% between September 2023 and August 2024, based on Clinical Data Analysis and Reporting System (CDARS) data. Despite established infection control measures, additional strategies are needed to reduce SSI risk. Silver has long been recognized for its antimicrobial properties, with efficacy demonstrated in both in-vitro and clinical studies. Silver-containing dressings (SD) release silver ions that act against bacteria, yeast, and viruses, thereby preventing or treating wound infections. SD has been applied to various surgical wounds, including clean closed incisions, and has been associated with reduced SSI rates. Application of SD to closed incision wounds after hip fracture surgery is therefore considered beneficial.
Objectives :
This project aims to standardize the application of SD in hip fracture surgery and evaluate its impact on SSI rates, and adverse reactions.
Methodology :
Guided by the Johns Hopkins Evidence-Based Practice (EBP) model (version 2025), a literature review was conducted and appraised using Johns Hopkins evidence appraisal tool, with findings consistently demonstrating benefits of SD in reducing SSI. Patients meeting defined inclusion criteria were recruited. SD was applied immediately after surgery and maintained until day 14 or suture/staple removal. Dressings were changed every seven days and discontinued if adverse reactions occurred. Patients were monitored for wound healing and complications.
Result & Outcome :
The project commenced in June 2025, and by mid-December 2025 a total of 176 patients had been recruited. The SSI rate decreased to 2.3%, compared with the baseline of 6%, and no adverse reactions were reported. Preliminary findings indicate that SD is effective in reducing postoperative infections. These improvements may contribute to reduced reliance on antibiotics and better wound healing, thereby enhancing patient care. From a nursing perspective, the reduced burden of infection management enables greater focus on rehabilitation support and patient education. Together, these dual benefits highlight SD as a valuable adjunct to infection control. Future directions include extending SD application to other surgical wounds, which could be considered to further improve outcomes and optimize resource utilization.
