SP 2.01 DRESSINg Trial: A Randomised Controlled Trial Assessing the Clinical Effectiveness of Dialkylcarbamoylchloride (DACC) Coated Dressings in the Prevention of Surgical Site Infection in Vascular Surgery
Arthur Lim, Ross Lathan, Josh Totty, Daniel Carradice, Ian Chetter, George SmithAbstract
Aim
Surgical site infections (SSI) in vascular surgery are associated with increased patient morbidity, mortality and healthcare costs worldwide. Dialkylcarbamoylchloride (DACC) is a synthetic material that irreversibly binds and inactivates bacteria exhibiting cell-surface hydrophobicity. The DRESSINg Trial aimed to assess the effectiveness of DACC-coated post-operative dressings in preventing SSI in vascular surgery.
Methods
This pragmatic, multicentre, randomised controlled trial (RCT) was conducted in the United Kingdom. Participants aged ≥ 18 years undergoing clean or clean-contaminated lower limb vascular surgery with primary wound closure were randomly assigned (1:1) to either DACC-coated dressings or standard surgical dressings. Follow-up occurred at 1 and 3 months post-surgery. Blinded wound assessment was performed either in person or remotely at Day 30. The primary outcome was the incidence of SSI; defined by Centres for Disease Control and Prevention (CDC) criteria or a total ASEPSIS score of ≥ 21 within 30 days of surgery.
Results
Between June 2021 and June 2025, 722 participants were recruited across 13 vascular centres, with 707 participants subsequently randomised (353 to DACC-coated dressings and 354 to standard dressings). Primary outcome data were available for 95.3% of the participants (342 DACC; 346 standard dressings). At day 30, intention-to-treat analysis demonstrated SSI occurred in 81/342 (23.7%) in the DACC group and 81/346 (23.4%) in the standard dressing group (risk ratio=1.01; 95% confidence interval = 0.77 - 1.32; p=0.933).
Conclusion
The DRESSINg trial provides level 1 evidence demonstrating no difference between DACC-coated dressings and standard dressings in preventing SSI following lower limb vascular surgery.