Jorge E. Marcet
Results of a study conducted by researchers at the University of South Florida and Tampa General Hospital show that the use of silver-plated nylon dressings for central venous catheters yielded a significant reduction in central line-associated blood infections among adult ICU patients.
“The CDC estimates that 30,000 to 40,000 central line-associated bloodstream infections (CLABSIs) occur annually in the U.S., and that patients who develop CLABSI while in the ICU have a mortality rate as high as 25%,” Jorge E. Marcet, MD, professor of surgery and division director of Colon and Rectal Surgery at the University of South Florida, told Infectious Disease News. “That’s a significant complication, and one that is thought to be mostly preventable.”
Marcet said the study was motivated by the impressive results that silver-plated dressings (Silverlon, Argentum Medical) have achieved in reducing surgical site infections in previous research.
“I had an interest in silver-plated wound dressings from prior work that we published,” he said. “In a prospective, randomized trial, [silver-plated dressings] demonstrated a 60% reduction in wound infection in patients undergoing colon and rectal operation.”
In a recent retrospective study, Marcet and colleagues reviewed 3,189 patient records and compared CLABSI rates among patients treated with chlorhexidine gluconate-impregnated sponge (CHGIS) dressings with those who received silver-plated dressings. Patients received CHGIS dressings between January 2009 and December 2009, and silver dressings were used between January 2010 and December 2010. CLABSI rates per 1,000 catheter days and ICU length of stay were defined as the study’s primary outcomes.
The researchers found a significantly lower rate of CLABSI incidence per 1,000 catheter days in the patients receiving silver-plated dressings (incidence rate ratio [IRR] = 0.54; 95% CI, 0.36-0.8). The silver-plated dressing group had a relative CLABSI risk of 0.502 (95% CI, 0.340-0.730; P < .001).
Moreover, Marcet and colleagues said the use of silver-plated dressings on all catheters would result in cost savings of $4,070 to $39,600 per 1,000 catheter days.
“When we did the math for our own institution, the savings were huge over that time period,” Marcet said. “There were 33 fewer CLABSIs over the study period in the silver dressings group. You can’t actually look at cost data, but if you look at well-accepted cost analysis, it’s estimated to be over $1 million in savings for the hospital.”
Additionally, the use of silver-plated dressings has enabled Tampa General Hospital to sustain the decreased CLABSI rate for 6 years. This result was achieved in seven different ICUs — including medical, coronary care, neurological, burn, surgical trauma, cardiothoracic and vascular.
Marcet said future studies will look at the potential of silver-plated dressings in other areas of medicine that use central lines, such as pediatrics, renal dialysis and non-ICU patients.
The use of silver-plated dressing technology may have even more widespread benefits. According to Raul Brizuela, CEO of Argentum Medical, the technology was awarded a contract with the Biomedical Advanced Research and Development Authority (BARDA) to study its use in mass casualty situations.
“If there were a chemical weapons attack, and sulfur mustard gas was diffused in an area, that would be one application we’re working on with BARDA,” Brizuela said. “Another is radiologically induced injuries. In the event of a nuclear detonation and radioactive fallout, they’re looking at our product as a possible medical countermeasure.” – by Jennifer Byrne
Karlnoski R, et al. J Intensive Care Medicine. 2017;doi:10.1177/0885066617745034.
Krieger BR, et al. Dis Colon Rectum. 2011;doi:10.1097/DCR.0b013e31821c495d.
Ozaki CK, et al. J Vasc Surg. 2015;doi:10.1016/j.jvs.2014.07.034.
Disclosures: Brizuela is CEO of Argentum Medical, LLC. Marcet reports no relevant financial disclosures.