↓ Skip to main content

Dressings for the prevention of surgical site infection

Overview of attention for article published in this source, December 2016
Altmetric Badge

Mentioned by

news
1 news outlet
twitter
93 tweeters
facebook
5 Facebook pages
wikipedia
1 Wikipedia page

Citations

dimensions_citation
26 Dimensions

Readers on

mendeley
290 Mendeley
You are seeing a free-to-access but limited selection of the activity Altmetric has collected about this research output. Click here to find out more.
Title
Dressings for the prevention of surgical site infection
Published by
John Wiley & Sons, Ltd, December 2016
DOI 10.1002/14651858.cd003091.pub4
Pubmed ID
Authors

Jo C Dumville, Trish A Gray, Catherine J Walter, Catherine A Sharp, Tamara Page, Rhiannon Macefield, Natalie Blencowe, Thomas KG Milne, Barnaby C Reeves, Jane Blazeby, Dumville, Jo C, Gray, Trish A, Walter, Catherine J, Sharp, Catherine A, Page, Tamara, Macefield, Rhiannon, Blencowe, Natalie, Milne, Thomas Kg, Reeves, Barnaby C, Blazeby, Jane, Milne, Thomas KG

Abstract

Surgical wounds (incisions) heal by primary intention when the wound edges are brought together and secured, often with sutures, staples, or clips. Wound dressings applied after wound closure may provide physical support, protection and absorb exudate. There are many different types of wound dressings available and wounds can also be left uncovered (exposed). Surgical site infection (SSI) is a common complication of wounds and this may be associated with using (or not using) dressings, or different types of dressing. To assess the effects of wound dressings compared with no wound dressings, and the effects of alternative wound dressings, in preventing SSIs in surgical wounds healing by primary intention. We searched the following databases: the Cochrane Wounds Specialised Register (searched 19 September 2016); the Cochrane Central Register of Controlled Trials (CENTRAL; the Cochrane Library 2016, Issue 8); Ovid MEDLINE (including In-Process & Other Non-Indexed Citations, MEDLINE Daily and Epub Ahead of Print; 1946 to 19 September 2016); Ovid Embase (1974 to 19 September 2016); EBSCO CINAHL Plus (1937 to 19 September 2016).There were no restrictions based on language, date of publication or study setting. Randomised controlled trials (RCTs) comparing wound dressings with wound exposure (no dressing) or alternative wound dressings for the postoperative management of surgical wounds healing by primary intention. Two review authors performed study selection, 'Risk of bias' assessment and data extraction independently. We included 29 trials (5718 participants). All studies except one were at an unclear or high risk of bias. Studies were small, reported low numbers of SSI events and were often not clearly reported. There were 16 trials that included people with wounds resulting from surgical procedures with a 'clean' classification, five trials that included people undergoing what was considered 'clean/contaminated' surgery, with the remaining studies including people undergoing a variety of surgical procedures with different contamination classifications. Four trials compared wound dressings with no wound dressing (wound exposure); the remaining 25 studies compared alternative dressing types, with the majority comparing a basic wound contact dressing with film dressings, silver dressings or hydrocolloid dressings. The review contains 11 comparisons in total. SSIIt is uncertain whether wound exposure or any dressing reduces or increases the risk of SSI compared with alternative options investigated: we assessed the certainty of evidence as very low for most comparisons (and low for others), with downgrading (according to GRADE criteria) largely due to risk of bias and imprecision. We summarise the results of comparisons with meta-analysed data below:- film dressings compared with basic wound contact dressings following clean surgery (RR 1.34, 95% CI 0.70 to 2.55), very low certainty evidence downgraded once for risk of bias and twice for imprecision.- hydrocolloid dressings compared with basic wound contact dressings following clean surgery (RR 0.91, 95% CI 0.30 to 2.78), very low certainty evidence downgraded once for risk of bias and twice for imprecision.- hydrocolloid dressings compared with basic wound contact dressings following potentially contaminated surgery (RR 0.57, 95% CI 0.22 to 1.51), very low certainty evidence downgraded twice for risk of bias and twice for imprecision.- silver-containing dressings compared with basic wound contact dressings following clean surgery (RR 1.11, 95% CI 0.47 to 2.62), very low certainty evidence downgraded once for risk of bias and twice for imprecision.- silver-containing dressings compared with basic wound contact dressings following potentially contaminated surgery (RR 0.83, 95% CI 0.51 to 1.37), very low certainty evidence downgraded twice for risk of bias and twice for imprecision. Secondary outcomesThere was limited and low or very low certainty evidence on secondary outcomes such as scarring, acceptability of dressing and ease of removal, and uncertainty whether wound dressings influenced these outcomes. It is uncertain whether covering surgical wounds healing by primary intention with wound dressings reduces the risk of SSI, or whether any particular wound dressing is more effective than others in reducing the risk of SSI, improving scarring, reducing pain, improving acceptability to patients, or is easier to remove. Most studies in this review were small and at a high or unclear risk of bias. Based on the current evidence, decision makers may wish to base decisions about how to dress a wound following surgery on dressing costs as well as patient preference.

Twitter Demographics

The data shown below were collected from the profiles of 93 tweeters who shared this research output. Click here to find out more about how the information was compiled.

Mendeley readers

The data shown below were compiled from readership statistics for 290 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
United States 3 1%
Brazil 2 <1%
Spain 2 <1%
Japan 1 <1%
United Kingdom 1 <1%
Unknown 281 97%

Demographic breakdown

Readers by professional status Count As %
Student > Master 54 19%
Researcher 44 15%
Student > Bachelor 43 15%
Student > Doctoral Student 30 10%
Other 27 9%
Other 92 32%
Readers by discipline Count As %
Medicine and Dentistry 155 53%
Unspecified 37 13%
Nursing and Health Professions 34 12%
Agricultural and Biological Sciences 16 6%
Psychology 8 3%
Other 40 14%