Abstract
<title>Abstract</title> <p> <bold>Background</bold> Surgical site infection (SSI) remains a common complication after pancreatic surgery and is associated with increased morbidity. Dialkylcarbamoyl chloride (DACC)-coated dressings reduce bacterial burden through hydrophobic binding of microorganisms; however, their effectiveness after pancreatic surgery and their interaction with patient nutritional status remain unclear. This study evaluated postoperative wound outcomes according to dressing type and preoperative nutritional status. <bold>Methods</bold> This retrospective cohort study included 50 patients who underwent pancreatic resection between July 2024 and October 2025. Postoperative wound management was performed using either DACC-coated or standard dressings (n = 22 and 28, respectively). Preoperative nutritional status was assessed using the prognostic nutritional index (PNI) and controlling nutritional status (CONUT) score. The primary outcome was surgical site infection (SSI), and secondary outcomes included clinical seroma and seroma detected on postoperative day 5 using abdominopelvic computed tomography. Multivariable logistic regression, receiver operating characteristic analysis, and exploratory interaction analyses were performed to evaluate factors associated with SSI. <bold>Results</bold> The overall SSI rate did not differ significantly between the two groups (31.8% vs. 39.3%, p = 0.803). Advanced age and pylorus-preserving pancreaticoduodenectomy (PPPD) showed associations with SSI, whereas lower PNI demonstrated a borderline association. The multivariable logistic regression model demonstrated good discrimination, with an area under the receiver operating characteristic curve of 0.864 (95% confidence interval 0.807–0.981). In dressing-stratified analyses, lower PNI was significantly associated with SSI only in the standard dressing group. However, formal interaction analysis between dressing type and PNI was not statistically significant. <bold>Conclusions</bold> Overall postoperative wound outcomes were comparable between DACC-coated and standard dressings after pancreatic surgery. Exploratory analyses suggested differing associations between nutritional status and SSI according to dressing type; however, these findings should be considered hypothesis-generating and warrant validation in larger prospective studies. <bold>Trial registration</bold> Not applicable. </p>