Can I apply Adaptic (cellulose-based dressing) on top of Surgicel (oxidized regenerated cellulose)?

Applying Adaptic on Top of Surgicel: Compatibility and Recommendations

Applying Adaptic on top of Surgicel is not recommended as there is no evidence supporting the combined use of multiple antimicrobial dressings, and this practice may potentially interfere with the proper function of each material.

Understanding the Materials

• Surgicel (oxidized regenerated cellulose) is a sterile, absorbable hemostatic agent primarily used to control bleeding during surgical procedures 1
• Adaptic is a cellulose-based dressing used for wound management
• Both materials have distinct functions that may be compromised when used together

Evidence-Based Recommendations

Potential Issues with Combined Use

• The Centers for Disease Control and Prevention recommends choosing a single antimicrobial approach rather than layering multiple antimicrobial agents without evidence supporting their combined use 2
• The American Diabetes Association warns against using multiple antimicrobial agents simultaneously without evidence for improved outcomes 2
• There is no evidence that combining these materials provides additive or synergistic effects 2

Proper Wound Management Principles

• Advanced dressings of any type should not be used for primarily closed surgical wounds for the purpose of preventing surgical site infections 3
• The WHO Global Guidelines for the Prevention of SSIs suggest not using any type of advanced dressing over a standard dressing on primarily closed surgical wounds 3
• Decision-makers should base decisions about wound dressings on costs and patient preference rather than assumed benefits 3

Material-Specific Considerations

Surgicel Properties and Concerns

• Surgicel is designed to be absorbed by the body over time and has bactericidal properties against antibiotic-resistant organisms 1
• Surgicel should be removed when used around areas of bony confine or near neural structures as it may swell and cause unwanted pressure 1
• Studies show that cellulose-based materials like Surgicel are associated with minimal morbidity in wound healing 4

Dressing Selection Principles

• Dressings should be selected primarily based on exudate control and comfort rather than for antimicrobial properties alone 2
• The surgical wound dressing should be kept undisturbed for a minimum of 48 hours after surgery unless leakage occurs 3

Common Pitfalls to Avoid

• Selecting dressings based on antimicrobial properties rather than exudate management needs 2
• Assuming that combining antimicrobial agents will provide additive or synergistic effects without evidence 2
• Using multiple layers of different materials may interfere with the proper function of each material and potentially delay wound healing 4

Alternative Approach

• Choose either Surgicel or Adaptic based on the specific wound needs rather than using both together 2
• If hemostasis is the primary concern, Surgicel alone may be sufficient 1, 5
• If wound protection is needed after hemostasis is achieved, consider removing Surgicel before applying an appropriate wound dressing 3