Gentamicin-Collagen Sponges for the Prevention of Surgical Site Infections: A Meta-Analysis of Randomized Controlled Trials.

Abstract

To study the effectiveness of gentamicin-collagen sponges (GCS) for the prevention of surgical site infections (SSIs). A systematic search of the PubMed and Scopus databases was performed (up to April 2015) to identify randomized controlled trials evaluating the efficacy of GCS for the prevention of SSIs. A random effects model was applied. Twenty-one RCTs (8,472 patients) were included. Gentamicin-collagen sponges were associated with a lower risk of SSIs (risk ratio [RR] 0.65; 95% confidence interval [CI] 0.49-0.84). Based on Jadad scores, a lower risk for the development of SSI was presented in lower-quality studies (Jadad <3; RR 0.44; 95% CI 0.27-0.71), but no difference was observed in high-quality studies (Jadad ≥3; RR 0.77; 95% CI 0.58-1.02). No difference was observed in all-cause deaths in the GCS group compared with the control group (RR 0.77; 95% CI 0.56-1.06). When analyzing lower-quality studies or only clean procedures, GCS significantly reduced the risk of SSI. Further high-quality randomized studies are needed to confirm the benefit of GCS for lowering mortality rates.