Evaluation of different surgical dressings in reducing postoperative surgical site infection of a closed wound: A network meta-analysis
Nanhui Jiang, Fengying Rao, Jiahong Xiao, Jian Yang, Wei Wang, Zhen Li, Rong Huang, Zhisu Liu, Tao Guo
Abstract
To evaluate the effects of different surgical dressings in reducing surgical site infection (SSI) and identify the optimal dressings. Randomized controlled trials investigating the application of surgical dressings were retrieved from electronic databases, including MEDLINE, EMBASE, and the Cochrane Library. The odds ratios (ORs) of the SSI rate were compared by direct meta-analysis, and the surface under the cumulative ranking (SUCRA) curve values were calculated based on the Bayesian theorem. A node-splitting model was applied to analyse the consistency of the comprehensive comparison results. Twenty-two studies containing 5487 participants were pooled for the comprehensive comparison. Among all the studies included, 9 types of surgical dressings were identified for comparison. The results of the direct meta-analysis revealed that novel dressings significantly reduced the overall SSI rate with an OR of 1.026 (95% CI: 1.013–1.040, p < 0.001), which was determined to have low heterogeneity (I2 = 32.1%). Specifically, 3 types of dressings presented significant effects in reducing SSI, namely, mupirocin-containing (OR = 1.076, 95% CI: 1.014–1.142, p = 0.015), dialkylcarbamoyl-chloride-containing (OR = 1.047, 95% CI: 1.012–1.083, p = 0.008) and vitamin E (VE)-silicone-containing (OR = 1.129, 95% CI: 1.016–1.255, p = 0.025) dressings. Network meta-analysis demonstrated that the VE-silicone dressing (SUCRA = 0.37) was the optimal dressing, followed by the mupirocin dressing, with a SUCRA of 0.31. The present network meta-analysis identified the superiority of VE-silicone and mupirocin dressings in preventing SSI. The evidence-based results provide suggestions and directions for future investigations on surgical dressings. More large-scale trials with rigorous designs are warranted to clarify the clinical value of novel dressings in surgical incision management.