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Dressing to prevent surgical site infection in adult patients with cancer: a systematic review with meta-analysis

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Abstract 

Purpose

To identify the most effective dressing for application to surgical wounds with primary closure to prevent surgical site infection (SSI) in adult patients with cancer undergoing elective surgeries.

Methods

This systematic review was based on the Preferred Reporting Items for Systematic Reviews and Meta-Analysis, with online searches conducted in the CINHAL, Cochrane Central, LILACS, PubMed, Scopus, Embase, Livivo, and Web of Science databases. An additional search was conducted in gray literature using Google Scholar. The risk of bias was assessed using RoB 2.0. The certainty of evidence was evaluated using the Grading of Recommendations Assessment and Development and Evaluation, and the results were synthesized in a descriptive manner and using meta-analysis.

Results

Eleven randomized clinical trials were conducted to compare different types of dressing—silver dressing with absorbent dressing (n = 3), mupirocin dressing with paraffin/no dressing (n = 1), honey-based dressing with absorbent dressing (n = 1), vitamin E and silicone-containing dressing with absorbent dressing (n = 1), and negative pressure wound therapy with absorbent dressing (n = 4)—and compare the usage duration of absorbent dressing (n = 1). Nine trials presented a low risk of bias, and two were classified as having uncertain bias. Compared with absorbent dressing, silver dressing did not reduce the risk of developing any type of SSI in 894 clinical trial participants (risk relative RR: 0.72; 95% confidence interval [CI] [0.44, 1.17] p = 0.18). Compared with absorbent dressing, negative pressure wound therapy did not reduce the risk of developing any type of SSI in the 1041 participants of two clinical trials (RR 0.68; 95% CI [0.31, 1.26] p = 0.22). The certainty of evidence of the three meta-analyses was considered low or very low for the prevention of SSI. We believe that this low certainty of evidence can be improved by conducting new studies in the future.

Conclusion

There is no evidence regarding which dressing is the most effective in preventing SSI in adult patients with cancer.

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Fig. 1

Source: Page et al. [10]

Fig. 2
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Data Availability

Data supporting this review are available within the study and its supplementary material.

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Authors and Affiliations

  1. Ribeirão Preto School of Nursing, University of São Paulo (EERP/USP), Prof. Hélio Lourenço St., 3900, Ribeirão Preto, Sao Paulo, Vila Monte Alegre, Brazil

    Thais Almeida Dias, Daiane Rubinato Fernandes, Bruna Nogueira dos Santos, Amanda Salles Margatho & Renata Cristina de Campos Pereira Silveira

  2. University of Brasilia, Asa Norte, Brasília, Distrito Federal, 70.910-900, Brazil

    Paula Elaine Diniz dos Reis

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Contributions

T.A.D. and D.R.F. performed literature searches. T.A.D. and D.R.F. performed data collection. T.A.D., D.R.F., B.N.S., and R.C.C.P.S. performed data analysis. T.A.D., B.N.S., P.E.D.R., A.S.M., and R.C.C.P.S. wrote the first draft and critically revised the manuscript. All the authors contributed to the study design and have read and approved the final manuscript.

Corresponding author

Correspondence to Renata Cristina de Campos Pereira Silveira.

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This is a systematic review; no ethical approval is required.

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This was a systematic review, and informed consent was not required.

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This was a systematic review with no human research participants.

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The authors declare no competing interests.

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Dias, T.A., Fernandes, D.R., dos Santos, B.N. et al. Dressing to prevent surgical site infection in adult patients with cancer: a systematic review with meta-analysis. Support Care Cancer 31, 11 (2023). https://doi.org/10.1007/s00520-022-07467-8

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