PADDI Trial results announced

06 May 2021

A large scale trial by Monash University has definitively found a drug commonly used during anaesthesia before surgery to prevent nausea and vomiting does not increase the risk of a surgical wound infection as once feared.

The steroid drug, dexamethasone, is often given by anaesthetists during surgery. However, because of its effects on the immune system there has been growing concern that it may increase the risk of wound infections, particularly in vulnerable populations such as patients with diabetes.
 
As a result, there has been a reluctance to use it, even though more than half of patients are at risk of experiencing nausea and vomiting after surgery. The same drug has recently been shown to decrease the risk of death from COVID-19 in severely ill patients.  
 
Now, the Perioperative Administration of Dexamethasone and Infection Trial (PADDI), led by Professor Tomás Corcoran, Director of Research in the Department of Anaesthesia and Pain Medicine, Royal Perth Hospital has found that administering a low-dose of dexamethasone during anaesthesia for surgical operations does not increase the risk of surgical wound infections.

The trial's findings from 55 hospitals and 8735 patients across Australia, New Zealand, Hong Kong and South Africa have implications for patient safety and clinical practice and have today been published in The New England Journal of Medicine.

The results were announced in a webinar streamed from the Alfred hospital in Melbourne on Thursday 6 May. Professor Corcoran and FANZCA Professor Paul Myles were joined by Associate Professor Trisha Peel, Professor Allen Cheng and ANZCA Clinical Trials Network Manager Karen Goulding. They discussed the rationale of the PADDI trial, the epidemiology and significance of surgical site infections, the concept of non-inferiority trials and the outstanding contribution of the ANZCA CTN.

Webinar recording
The webinar recording of the results of the Perioperative Administration of Dexamethasone and Infection (PADDI) trial held on Thursday 6 May, 2021 is now available on YouTube: https://youtu.be/-XdkpDmD1rM