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Gentamicin/collagen sponge use may reduce the risk of surgical site infections for patients undergoing cardiac operations: a meta-analysis.

Formanek MB, Herwaldt LA, Perencevich EN, Schweizer ML. Gentamicin/collagen sponge use may reduce the risk of surgical site infections for patients undergoing cardiac operations: a meta-analysis. Surgical Infections. 2014 Jun 1; 15(3):244-55.

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OBJECTIVE: A meta-analysis of all published randomized controlled trials of the effectiveness of gentamicin/collagen sponges for preventing surgical site infections (SSIs). BACKGROUND: Despite routine use of systemic prophylactic antimicrobial agents, SSIs continue to be associated with substantial morbidity. RESULTS conflict of studies of the efficacy of gentamicin/collagen sponges for preventing SSIs. However, many of these studies have assessed sponge use in only a single specific type of operation. The general effect of sponge use among different types of operations has not been previously assessed. METHODS: The PubMed and Cumulative Index to Nursing and Allied Health Literature (CINAHL) databases were searched for articles appearing from 1990 through January 2012 that were related to gentamicin/collagen sponge use and SSIs. Summary estimates were obtained through a random effects model. After reviewing 714 article abstracts and reviewing 22 articles in detail, we pooled the odds ratios (OR) for 13 independent study populations (cardiac, n = 4; colorectal, n = 4; pilonidal sinus, n = 2; hernia, n = 2; gastrointestinal, n = 1) in which the association between prophylactic use of gentamicin/collagen sponges and SSIs was assessed. RESULTS: Pooling of the results of all studies included in the review in a random effects model showed a significant protective effect of prophylactic use of gentamicin/collagen sponges against SSI (pooled OR: 0.66; 95% confidence interval [CI]: 0.45, 0.97; n = 13). However, when the data were stratified by type of operation, a significant protective effect was observed in cardiac procedures (pooled OR: 0.59; 95% CI: 0.37, 0.96; n = 4) but not in colorectal procedures (pooled OR: 0.74; 95% CI: 0.29-1.92; n = 4). CONCLUSION: Use of gentamicin/collagen sponges was associated with a reduced risk of SSI following cardiac operations but not following colorectal procedures.

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