Objective:

To evaluate whether the use of a silver-impregnated occlusive dressing is associated with a lower incidence of acute surgical site infection compared with standard sterile dressing in patients undergoing direct anterior total hip arthroplasty.

Approach:

• Patient Selection: Retrospective review of 321 patients who underwent primary THA via DAA from September 2020 to December 2025, excluding certain cases to mitigate early learning-curve effects.
• Surgical Technique: All procedures performed by a single surgeon using a lateralized incision to reduce inguinal fold contact.
• Dressing Protocol: Standard sterile gauze was used until August 2021, after which AQUACEL® Ag SURGICAL was implemented, with dressing changes every 7 days.
• Outcome Measures: Primary outcome was acute surgical site infection within 30 days; secondary outcomes included periprosthetic joint infection and return to OR for wound-related complications within 90 days.
• Data Analysis: Data analyzed using IBM SPSS Statistics; comparisons made using appropriate statistical tests.

Key Findings:

• The use of silver-impregnated occlusive dressings was associated with a lower incidence of acute surgical site infections compared to standard sterile dressings.
• The study included a total of 321 patients with a follow-up period of at least three months.

Interpretation:

Limitations:

• Retrospective design may introduce bias.
• No a priori power analysis was performed.

Conclusion: