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Am J Perinatol 2023; 40(16): 1811-1819
DOI: 10.1055/s-0041-1739521
Original Article

Effect of Using Silver Nylon Dressings on Postoperative Pain after Cesarean Delivery

Sheila Connery 
1   Department of Obstetrics and Gynecology, Morsani College of Medicine, University of South Florida, Tampa, Florida
,
Jean Paul Tanner
2   College of Public Health, University of South Florida, Tampa, Florida
,
Linda Odibo
1   Department of Obstetrics and Gynecology, Morsani College of Medicine, University of South Florida, Tampa, Florida
,
Olivia Raitano
3   Creighton University School of Medicine, Omaha, Nebraska
,
Dusan Nikolic-Dorschel
2   College of Public Health, University of South Florida, Tampa, Florida
,
Judette M. Louis
1   Department of Obstetrics and Gynecology, Morsani College of Medicine, University of South Florida, Tampa, Florida
› Author Affiliations Funding This work was partially supported by a grant from Argentum Medical, LLC, Chicago, IL. This study was an investigator-initiated trial with Argentum Medical providing financial support to the University of South Florida in the form of a study grant. Study design, data accrual, and data analysis were accomplished independent of the sponsor. None of the investigators is consultants or receive any honoraria from the sponsor.
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Abstract

Objective Silver dressings have been associated with a decrease in postoperative pain in selected populations, but it is unknown if the benefit can be observed after cesarean deliveries. We sought to evaluate the impact of silver nylon dressings in reducing postoperative pain after cesarean delivery.

Study Design A secondary analysis of data from a blinded randomized clinical trial of women undergoing cesarean delivery scheduled and unscheduled at a single site was conducted. Women were recruited for participation from a single site and randomized to a silver nylon dressing or an identical-appearing gauze wound dressing. Wounds were evaluated in the outpatient clinic at 1 and 6 weeks after delivery and patient responded to the modified patient scar assessment scale. The primary outcome of this analysis was inpatient opioid and nonopioid analgesic dispensed. The secondary outcome was patient-reported pain at the 1- and 6-week postpartum visits. Data were analyzed using chi-square test, Student's t-test, Fisher's exact test, Wilcoxon–Mann–Whitney's test, and logistic regression where appropriate. A p-value of < 0.05 was considered significant.

Results Among the 649 participants, women allocated to the silver nylon dressing group, when compared with the gauze group, were similar in the amount of dispensed opioid and nonopioid analgesic medications (morphine equivalent milligrams of opioids dispensed [82.5 vs. 90 mg, p = 0.74], intravenous nonsteroidal anti-inflammatory drugs (NSAIDs) [120 vs. 120 mg, p = 0.55], and oral NSAIDs [4,800 vs. 5,600 mg in the gauze group, p = 0.65]). After adjusting for confounding variables, postoperative wound infection (adjusted odds ratio [aOR]: 11.70; 95% confidence interval [CI]: 4.51–30.31) at 1-week postoperative and again at 6-week postoperative (aOR: 5.59; 95% CI: 1.03–30.31) but not gauze dressing was associated with patient-reported postoperative pain.

Conclusion Among women undergoing cesarean delivery, silver nylon dressing was not associated with a reduction in postoperative pain.

Key Points

  • Silver dressings showed no decrease in pain medications.

  • Wound infection is associated with pain postoperatively.

  • Silver dressings did not reduce postoperative pain.

Keywords

cesarean delivery - general anesthesia - opioid medications - postoperative pain - silver dressings - wound infection

Note

This study was conducted in Tampa, FL.




Publication History

Received: 30 October 2020

Accepted: 04 October 2021

Article published online:
28 November 2021

© 2021. Thieme. All rights reserved.

Thieme Medical Publishers, Inc.
333 Seventh Avenue, 18th Floor, New York, NY 10001, USA

 

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