Smart pH/Temperature-sensing occlusive dressing vs standard gauze for early detection of surgical-site infection after clean-contaminated open abdominal surgery: A randomized controlled trial

Background: Surgical-site infections (SSIs) remain a prevalent postoperative complication in clean-contaminated abdominal surgeries, particularly in resource-limited settings. Standard gauze dressings lack the ability to provide early physiological indicators of infection, often resulting in delayed treatment. This randomized controlled trial evaluated the effectiveness of a smart occlusive dressing embedded with pH and temperature sensors for early detection of SSI. Methods: A total of 200 patients undergoing clean-contaminated open abdominal surgery in a tertiary hospital in Iraq were randomized to receive either the smart dressing (n=100) or standard sterile gauze (n=100). The primary outcome was incidence of CDC/NHSN-defined SSI within the surveillance window. Secondary outcomes included time to treatment initiation, duration of postoperative hospital stay, inflammatory biomarker levels, and patient-centered outcomes. Continuous variables were analyzed using independent samples t-tests; categorical variables were assessed using Chi-square or Fisher's exact tests. A p-value