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      Assessing the effectiveness of dialkylcarbamoylchloride (DACC)-coated post-operative dressings versus standard care in the prevention of surgical site infection in clean or clean-contaminated, vascular surgery (the DRESSINg trial): study protocol for a pilot feasibility randomised controlled trial

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          Abstract

          Background

          Surgical site infection in vascular surgery has a reported incidence of up to 19%. A novel method of reducing this rate of infection is dressings coated with dialkylcarbamoylchloride (DACC), a hydrophobic wound contact layer that binds bacteria and removes them from the wound bed. Early research has suggested that DACC-coated wound dressings are effective in reducing surgical site infection when applied to wounds healing by primary intention post-operatively, therefore this trial aims to assess the feasibility of producing high-quality evidence assessing this theory.

          Methods

          Patients undergoing clean or clean-contaminated vascular surgery will be randomised to have their surgical wounds dressed with a DACC-coated dressing or a non-coated occlusive absorbent post-operative dressing. All other aspects of their peri-operative care will be standardised or carried out in line with hospital policy. Wound assessments will be carried out between day 5–7, day 30 (± 3 days) and 6 months post-operatively (± 7 days) by a blinded assessor using the ASEPSIS scoring tool. Quality of life data using EQ-5D and SF-36, resource use and mortality data will also be collected. This feasibility trial will dictate the conduct of a full-scale trial through the collection of data on recruitment and retention rates, and fitness-for-purpose of the follow-up arrangements.

          Discussion

          Surgical site infections are now the second most common hospital acquired infections with a significant cost implication. The aim of the DRESSINg trial is to investigate the effectiveness of a novel preventative measure at reducing wound infections post-surgery and will provide robust evidence to support or deny its use.

          Trial registration

          Clinicaltrials.gov identifier: NCT02992951, Registered 12/12/16. REC Reference: 16/LO/2135.

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          Most cited references16

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          Assessment of the SF-36 version 2 in the United Kingdom

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            Test-retest reliability of health state valuations collected with the EuroQol questionnaire.

            This study is a contribution by the Dutch participants to the research programme of the EuroQol Group. This collaborative group of researchers engaged in outcome measurement is working towards the development of a standardized, non-disease-specific instrument for describing and particularly valuing health-related quality of life. The present article analyses the test-retest reliability of the valuations collected with the EuroQol questionnaire in a population survey (n = 208). The choice of the appropriate method for test-retest analysis is discussed and the results of several approaches with the EuroQol data are shown. Generalizability Theory is proposed as the most suitable method. This method is the most comprehensive, giving distinct information about the relative contributions of different sources of variance. The EuroQol valuations appear to have good test-retest reliability.
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              Comparison of the EQ-5D and SF-12 health surveys in a general population survey in Alberta, Canada.

              The purposes of this analysis were to evaluate the construct validity of the EQ-5D and compare responses on the EQ-5D with the Physical Component Summary (PCS-12) and Mental Component Summary (MCS-12) scores of the SF-12 Health Survey. Data were collected via a survey instrument mailed to 4,200 randomly selected subjects in the province of Alberta, Canada. The instrument contained the EQ-5D and SF-12 health surveys, with additional questions eliciting clinical and demographic information from the respondents. 1,555 respondents returned mailed questionnaires; 606 questionnaires were returned undeliverable. The SF-12 summary scores were calculated for 1,380 respondents. Analysis of the EQ-5D responses by demographic variables found significant differences among categories of age, gender, and self-reported chronic medical conditions. Corresponding dimensions and summary scores were more strongly related (eg, mobility and PCS-12; F ratio = 598.3, P < 0.001) than dissimilar dimensions (eg, mobility and MCS-12; F ratio = 18.8, P < 0.001). The EQ-5D index scores were moderately correlated with SF-12 summary scores (r = 0.41 for MCS-12 and r = 0.68 for PCS-12). For subjects reporting no problems on the EQ-5D, PCS-12 and MCS-12 scores were significantly lower for people reporting medical problems or feelings of depression. The results of this investigation generally supported the validity of the EQ-5D. However, an important ceiling effect was observed for the EQ-5D in this sample. The combination of the EQ-5D and SF-12 provides relatively broad coverage of important health domains and scores for various purposes.
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                Author and article information

                Contributors
                (+44) 01482 674643 , hy9jpt@hyms.ac.uk
                Journal
                Pilot Feasibility Stud
                Pilot Feasibility Stud
                Pilot and Feasibility Studies
                BioMed Central (London )
                2055-5784
                18 January 2019
                18 January 2019
                2019
                : 5
                : 11
                Affiliations
                ISNI 0000 0004 0400 5212, GRID grid.417704.1, Academic Vascular Surgical Unit, , Hull Royal Infirmary, ; Anlaby Road, Hull, HU3 2JZ UK
                Author information
                http://orcid.org/0000-0002-0063-1414
                Article
                400
                10.1186/s40814-019-0400-2
                6337832
                30680225
                632f5233-85fb-4839-bfba-308fdd053239
                © The Author(s). 2019

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 20 June 2018
                : 10 January 2019
                Categories
                Study Protocol
                Custom metadata
                © The Author(s) 2019

                infection,surgery,surgical wound,dialkylcarbamoylchloride,dacc,prevention

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