Dialkyl Carbamoyl Chloride (DACC)-Impregnated Dressings for the Prevention of Surgical Site Infections: Experience From a Multi-disciplinary Study in India

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. Methods This prospective, multicentre observational study was conducted after ethical committee approval across four centres in India, involving 106 patients (71 orthopaedic and 35 gastrointestinal) who received DACC-impregnated dressings. Dressings were applied immediately post-surgery and assessed over 30 days for the incidence of superficial or deep SSI. Additional evaluations included pain measured using visual analogue scale (VAS), dressing adhesion, patient satisfaction, and healthcare provider feedback. Statistical analyses included descriptive statistics and comparisons between time points using the Wilcoxon and Kruskal-Wallis tests, with a significance level set at p<0.05. Results Among the 106 patients, two (1.9%) cases of SSI were reported, both in orthopaedic patients. The dressings maintained at least 50% adhesion in 98.1% of cases. Pain levels using VAS averaged 3.9 (SD=2.6) at follow-up one and 2.8 (SD=2.8) at follow-up two. Patient satisfaction was high, with 73.5% reporting improved pain experiences during dressing changes compared to previous dressings. Healthcare professionals rated the handling of dressings as excellent in 89% of cases. Conclusion DACC-impregnated dressings demonstrated effectiveness in reducing SSIs in postoperative care for orthopaedic and gastrointestinal surgeries. The dressings were well-tolerated by patients and preferred by healthcare providers due to ease of use and high adherence. These findings support DACC-impregnated dressings as a safe and effective alternative for SSI prevention, particularly beneficial in reducing the risks associated with antimicrobial resistance. Further studies with larger sample sizes and controlled designs are recommended to validate these findings.