Dressings for the prevention of surgical site infection

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, 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

Abstract

Background: 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.

Objectives: 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.

Search methods: 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.

Selection criteria: 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.

Data collection and analysis: Two review authors performed study selection, 'Risk of bias' assessment and data extraction independently.

Main results: 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.

Primary outcome: 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.

Authors' conclusions: 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.

Conflict of interest statement

Jo Dumville: I receive research funding from the NIHR for the production of systematic reviews focusing on high priority Cochrane reviews in the prevention and treatment of wounds.

Trish Gray: none known

Catherine J Walter: none known.

Catherine Sharp: none known.

Tamara Page: none known.

Rhiannon Macefield: none known.

Natalie Blencowe: none known.

Thomas KG Milne: none known.

Barnaby Reeves is funded (both part salary and research consumables) in part by the NIHR Bristol Cardiovascular Biomedical Research Unit.

Jane Blazby: none known.

Figures

1
1
Study flow diagram.
2
2
Methodological quality summary: review authors' judgements about each methodological quality item for each included study.
1.1. Analysis
1.1. Analysis
Comparison 1 Basic wound contact dressings compared with exposed wounds, Outcome 1 Proportion of wounds with SSI.
2.1. Analysis
2.1. Analysis
Comparison 2 Film dressings compared with exposed wounds, Outcome 1 Proportion of wounds with SSI.
3.1. Analysis
3.1. Analysis
Comparison 3 Silver dressings compared with exposed wounds, Outcome 1 Proportion of wounds with SSI.
4.1. Analysis
4.1. Analysis
Comparison 4 Comparisons between basic wound contact dressings, Outcome 1 Proportion of wounds with SSI.
5.1. Analysis
5.1. Analysis
Comparison 5 Basic wound contact dressings compared with film dressings, Outcome 1 Proportion of wounds with SSI: clean surgery.
5.2. Analysis
5.2. Analysis
Comparison 5 Basic wound contact dressings compared with film dressings, Outcome 2 Proportion of wounds with SSI.
5.3. Analysis
5.3. Analysis
Comparison 5 Basic wound contact dressings compared with film dressings, Outcome 3 Pain associated with dressing (patient assessed).
5.4. Analysis
5.4. Analysis
Comparison 5 Basic wound contact dressings compared with film dressings, Outcome 4 Patient acceptability.
6.1. Analysis
6.1. Analysis
Comparison 6 Basic wound contact dressings compared with hydrocolloid dressings, Outcome 1 Proportion of wounds with SSI.
6.2. Analysis
6.2. Analysis
Comparison 6 Basic wound contact dressings compared with hydrocolloid dressings, Outcome 2 No pain on removal.
7.1. Analysis
7.1. Analysis
Comparison 7 Basic wound contact dressings compared with fibrous‐hydrocolloid (hydrofibre) dressings, Outcome 1 Proportion of wounds with SSI.
7.2. Analysis
7.2. Analysis
Comparison 7 Basic wound contact dressings compared with fibrous‐hydrocolloid (hydrofibre) dressings, Outcome 2 Proportion of wounds with SSI ‐ Vogt 2007 raw data.
8.1. Analysis
8.1. Analysis
Comparison 8 Basic wound contact dressings compared with matrix hydrocolloid dressings, Outcome 1 No pain on removal.
9.1. Analysis
9.1. Analysis
Comparison 9 Basic wound contact dressings compared with silver dressings, Outcome 1 Proportion of wounds with SSI.
10.1. Analysis
10.1. Analysis
Comparison 10 Basic wound contact dressing and non‐silver antimicrobial dressing, Outcome 1 Proportion of wounds with SSI.
11.1. Analysis
11.1. Analysis
Comparison 11 Comparisons between advanced dressings, Outcome 1 Proportion of wounds with SSI.

References

References to studies included in this review Bennett 2013 {published data only}

    1. Bennett K, Kellett W, Braun S, Spetalnick B, Huff B, Slaughter J, et al. Silver ion‐eluting dressings for prevention of post cesarean wound infection: a randomized, controlled trial. American Journal of Obstetrics and Gynecology 2013;208(Suppl 1):337.
Biffi 2012 {published data only}
    1. Biffi R, Fattori L, Bertani E, Radice D, Rotmensz N, Misitano P, et al. Surgical site infections following colorectal cancer surgery: a randomized prospective trial comparing common and advanced antimicrobial dressing containing ionic silver. World Journal of Surgical Oncology 2012;10:94.
Burke 2012 {published data only}
    1. Burke NG, Green C, McHugh G, McGolderick N, Kilcoyne C, Kenny P. A prospective randomised study comparing the jubilee dressing method to a standard adhesive dressing for total hip and knee replacements. Journal of Tissue Viability 2012;21:84‐7.
Cosker 2005 {published data only}
    1. Cosker T, Elsayed S, Gupta S, Mendonca AD, Tayton KJ. Choice of dressing has a major impact on blistering and healing outcomes in orthopaedic patients. Journal of Wound Care 2005;14(1):27‐9.
De Win 1998 {published data only}
    1. Win M, Blaere X, Scheers R. The effect of choice of surgical wound dressing on the direct cost of healing. Eighth European Conference on Advances in Wound Management, 1998 April 26‐28; Madrid, Spain. Madrid, 1998:54–7.
Dickinson Jennings 2015 {published data only}
    1. Dickinson Jennings C, Culver Clark R, Baker JW. A prospective, randomized controlled trial comparing 3 dressing types following sternotomy. Ostomy Wound Management 2015;61:42‐9.
Gardezi 1983 {published data only}
    1. Gardezi SA, Chaudhary AM, Sial AK, Ahmad I, Rashid M. Role of 'polyurethane membrane' in post operative wound management. The Journal of the Pakistan Medical Association 1983;33:219‐22.
Hewlett 1996 {published data only}
    1. Hewlett L. The evaluation of two post‐operative dressings in the management of surgical wounds. Fifth European Conference on Advances in Wound Management, 1995 November 21‐24; Harrogate, UK. 1996.
Holm 1998 {published data only}
    1. Holm C, Petersen JS, Gronboek F, Gottrup F. Effects of occlusive and conventional gauze dressings on incisional healing after abdominal wounds. European Journal of Surgery 1998;164:179‐83.
Kriegar 2011 {published data only}
    1. Krieger BR, Davis DM, Sanchez JE, Mateka JJ, Nfonsam VN, Frattini JC, et al. The use of silver nylon in preventing surgical site infections following colon and rectal surgery. Diseases of the Colon and Rectum 2011;54:1014‐9.
Langlois 2015 {published data only}
    1. Langlois J, Zaoui A, Ozil C, Courpied J‐P, Anract P, Hamadouche M. Randomized controlled trial of conventional versus modern surgical dressings following primary total hip and knee replacement. International Orthopaedics 2015;39:1315‐9.
Law 1987 {published data only}
    1. Law NH, Ellis H. Exposure of the wound ‐ a safe economy in the NHS. Postgraduate Medical Journal 1987;63:27‐8.
Lawrentschuk 2002 {published data only}
    1. Lawrentschuk N, Falkenburg MP, Pirpiris M. Wound blisters post hip surgery: a prospective trial comparing dressings. Australian and New Zealand Journal of Surgery 2002;72:716‐9.
Martin‐Trapero 2013 {published data only}
    1. Martin‐Trapero C, Martin‐Torrijos M, Fernandez‐Conde L, Torrijos‐Torrijos M, Manzano‐Martin E, Pacheco‐del Cerro JL, et al. Surgical site infections. Effectiveness of polyhexamethylene biguanide wound dressings. Enfermeria Clinica 2013;23:56‐61.
Michie 1994 {published data only}
    1. Michie DD, Hugill JV. Influence of occlusive and impregnated gauze dressings on incisional healing: a prospective randomized, controlled study. Annals of Plastic Surgery 1994;32:57‐64.
Moshakis 1984 {published data only}
    1. Moshakis V, Fordyce MJ, Griffiths JD, McKinna JA. Tegadern versus gauze dressing in breast surgery. British Journal of Clinical Practice 1984;38:149‐52.
Ozaki 2015 {published data only}
    1. Ozaki CK, Hamdan AD, Barshes NR, Wyers M, Hevelone ND, Belkin M, et al. Prospective, randomized, multi‐institutional clinical trial of a silver alginate dressing to reduce lower extremity vascular surgery wound complications. Journal of Vascular Surgery 2015;61:419‐27.
Persson 1995 {published data only}
    1. Persson M, Svenberg T, Poppen B. To dress or not to dress surgical wounds? Patients' attitudes to wound care after major abdominal operations. European Journal of Surgery 1995;161:791‐3.
Phan 1993 {published data only}
    1. Phan M, Auwera P, Andry G, Aoun M, Chantrain G, Deramaecker R, et al. Wound dressing in major head and neck cancer surgery: a prospective randomised study of gauze dressing vs sterile vaseline ointment. European Journal of Surgical Oncology 1993;19:10–6.
Politano 2011 {published data only}
    1. Politano A, Tracci M, Strider D, Sawyer R, Kern J, Upchurch G, et al. A randomized, prospective study of surgical site infections following vascular reconstructive surgery: untreated vs. silver‐impregnated dressings. 34th Annual Meeting of the Surgical Infection Society, 2014 May 1‐3; Baltimore (MD). 2014.
Prather 2011 {published data only}
    1. Prather AD, Mateka JJ, Marcet JE. Silver nylon wound dressings are associated with decreased post‐operative pain. Diseases of the Colon and Rectum 2011;45:5.
Ravnskog 2011 {published data only}
    1. Ravnskog FA, Espehaug B, Indrekvam K. Randomised clinical trial comparing Hydrofiber and alginate dressings post‐hip replacement. Journal of Wound Care 2011;20:136‐42.
Rohde 1979 {published data only}
    1. Rohde H, Thon K, Stoltzing H, Schirren J. The transparent adhesive drape as post‐operative dressing ‐ a randomised clinical study for comparison with a conventional dressing [Die Klarsicht‐Klebefolie als postoperativ Verband ‐ eine randomisierte, klinische Studie zum Vergleich mit einer konventionellen Verbandstechnik]. Der Chirurg 1981;52:46‐50.
Ruiz‐Tovar 2015 {published data only}
    1. Ruiz‐Tovar J, Llavero C, Morales V, Gamallo C. Total occlusive ionic silver‐containing dressing vs mupirocin ointment application vs conventional dressing in elective colorectal surgery: effect on incisional surgical site infection. Journal of the American College of Surgeons 2015;221:424‐9.
Shinohara 2008 {published data only}
    1. Shinohara T, Yamashita Y, Satoh K, Mikami K, Yamauchi Y, Hoshino S, et al. Prospective evaluation of occlusive hydrocolloid dressing regarding the healing effect after abdominal operations: randomised controlled trial. Asian Journal of Surgery 2008;31(1):1–5.
Siah 2011 {published data only}
    1. Siah CJ, Bacani CP, Yatim J. Effectivess of total occlusive ionic silver contained dressing in reducing bacterial growth and incidences of surgical site infections following open abdominal surgery‐a randomised controlled trial. Proceedings of Singapore Healthcare. 2011:193.
    1. Siah CJ, Yatim J. Efficacy of a total occlusive ionic silver‐containing dressing combination in decreasing risk of surgical site infection: an RCT. Journal of Wound Care 2011;20:561‐8.
Vogt 2007 {published data only}
    1. Vogt KC, Uhlyarik M, Schroeder TV. Moist wound healing compared with standard care of treatment of primary closed vascular surgical wounds: a prospective randomized controlled trial. Wound Repair and Regeneration 2007;15:624‐7.
Wikblad 1995 {published data only}
    1. Wikblad K, Anderson B. A comparison of three wound dressings in patients undergoing heart surgery. Nursing Research 1995;44(5):312‐6.
Wynne 2004 {published data only}
    1. Wynne R, Botti M, Stedman H, Holsworth L, Harinos M, Flavell O, et al. Effect of three wound dressings on infection, healing comfort, and cost in patients with sternotomy wounds: a randomised trial. Chest 2004;125(1):43‐9.
References to studies excluded from this review Abejon 2012 {published data only}
    1. Abejon A. The management of surgical wound: importance of the dressing. European Wound Management Association Journal 2012;12:129.
Abejon 2013 {published data only}
    1. Abejón A, Casanova PL, Verdú SJ, Torra I, Bou J‐E. Open‐label clinical trial comparing the clinical and economic effectiveness of using a polyurethane film surgical dressing with gauze surgical dressings in the care of post‐operative surgical wounds. International Wound Journal 2013;12:285‐92.
Ajao 1977 {published data only}
    1. Ajao OG. Surgical wound infection: a comparison between dressed and undressed wounds. Journal of Tropical Medicine and Hygiene 1977;80:192‐6.
Al‐Belasy 2003 {published data only}
    1. Al‐Belasy FA, Amer MZ. Hemostatic effect of n‐butyl‐2‐cyanoacrylate (histoacryl) glue in warfarin‐treated patients undergoing oral surgery. Journal of Oral and Maxillofacial Surgery 2003;61(12):1405‐9.
Allan 1996 {published data only}
    1. Allen RB, Kerstein M, Klassen H, Friedmann PS, Pryce DW, Lawrence JC, et al. Prospective study of clinical infections in wounds dressed with occlusive versus conventional dressings. Ninth Annual Symposium on Advanced Wound Care and Sixth Annual Medical Research Forum on Wound Repair, 1996 April 20‐24; Atlanta (GA). 1996:116.
Alsbjorn 1990 {published data only}
    1. Alsbjorn BF, Ovesen H, Walther‐Larsen S. Occlusive dressing versus petroleum gauze on drainage wounds. Acta Chirurgica Scandinavica 1990;156(3):211‐3.
Anonymous 2013 {published data only}
    1. Anonymous. SiiverSeal® dressing improves surgical wound outcomes. Wounds 2013;25:A18.
Baker 1977 {published data only}
    1. Baker H, Barnes RW, Shurr DG. The healing of below‐knee amputations: a comparison of soft and plaster dressing. American Journal of Surgery 1977;133(6):716‐8.
Blondeel 2004 {published data only}
    1. Blondeel PN, Murphy JW, Debrosse D, Nix II, Puls LE, Theodore N, Coulthard P. Closure of long surgical incisions with a new formulation of 2‐octylcyanoacrylate tissue adhesive versus commercially available methods. American Journal of Surgery 2004;188:307‐13.
Borgognoni 2000 {unpublished data only}
    1. Borgognoni L, Martini L, Brandani P, Pelliccia L, Reali UM. The use of silicone gel sheeting in the prevention of recurrence after keloid excision: a clinical and immunohistochemical investigation. Wound Repair and Regeneration 2000;8(5):A408‐A409.
Borkar 2011 {published data only}
    1. Borkar NB, Khubalkar MV. Are postoperative dressings necessary?. Journal of Wound Care 2011;20:301‐3.
Boyce 1995 {published data only}
    1. Boyce DE, Miller L, Moore K, Harding KG. An open comparative randomized parallel‐group clinical trial to evaluate the performance of Hyaff[TM] wound dressing in the management of pilonidal sinus excision wounds: an interim analysis. Sixth European Conference on Advances in Wound Management; 1995 November 21‐24; Harrogate, UK. 1997:55‐6.
Brehant 2009 {published data only}
    1. Brehant O, Pessaux P, Regenet N, Tuech JJ, Panaro F, Mantion G, et al. Healing of stoma orifices: multicenter, prospective, randomized study comparing calcium alginate mesh and polyvidone iodine mesh. World Journal of Surgery 2009;33:1795‐801.
Cabrales 2014 {published data only}
    1. Cabrales RA, Cobo RB, Patino YD, Quintero MF, Martinez JW, Upegui ML. Effectiveness of silver dressings in preventing surgical site infection in contaminated wounds. Latreia 2014;27:247‐54.
Choi 2005 {published data only}
    1. Choi JW, Hyun KB, Kim YO, Park BY. Comparing conventional suture method versus wound closure using tissue glue (Histoacryl Blue®): a prospective randomised clinical trial. Journal of the Korean Society for Plastic and Reconstructive Surgery 2005;32(1):19‐23.
Chou 2010 {published data only}
    1. Chou D, Cheng J, Chesnut R, Choudhri H, Gopinath S, Scott Graham R, et al. A prospective, multi‐center, randomized controlled study to compare a low swell formulation of a PEG hydrogel spinal sealant as an adjunct to sutured dural repair with common dural sealing methods. Fifth Annual Meeting of the North American Spine Society. 2010.
Chrintz 1989 {unpublished data only}
    1. Chrintz H, Vibits H, Cordtz TO, Harreby JS, Waaddegaard P, Larsen SO. Discontinuing postoperative wound dressings [Seponering af postoperativ sarforbinding]. Ugeskrift for Laeger 1989;151(41):2667‐8.
    1. Chrintz H, Vibits H, Cordtz TO, Harreby JS, Waaddegaard P, Larsen SO. Need for surgical wound dressing. British Journal of Surgery 1989;76:204‐5.
Colom Majan 2002 {published data only}
    1. Colom Majan JI. Treatment with a self‐adherent soft silicone gel dressing versus no treatment on postoperative scars. Twelfth Conference of the European Wound Management Association, 2002 May 23‐25; Granada, Spain. 2002.
Decaillet 1998 {published data only}
    1. Decaillet JM. Use of a new hydrocolloid dressing on sutured wounds after hand surgery. Eighth Conference of the European Wound Management Association, 1998 April, Madrid, Spain. 1998.
Dell 2001 {published data only}
    1. Dell SJ, Hovanesian JA, Raizman MB, Crandall AS, Doane J, Snyder M. Randomized comparison of postoperative use of hydrogel ocular bandage and collagen corneal shield for wound protection and patient tolerability after cataract surgery. Journal of Cataract and Refractive Surgery 2011;37:1113‐21.
Dillon 2008 {published data only}
    1. Dillon J, Sayer R, Clarke J, McLean I. Evaluation of a hydrofibre/hydrocolloid dressing in a district general hospital. European Wound Management Association Journal 2008;2(Supp):263, Abstract P320.
Di Maggio 1994 {published data only}
    1. Maggio MR, Sakamoto N, Curutchet HP. Comparative study of the evolution of surgical wounds treated with conventional healing topical agents or silicone oil [Estudio comparativo de la evolucion de las heridas quirurgicas cubiertas con curacion convencional o con aceite de siliconas]. La Prensa Médica Argentina 1994;81:194‐6.
Dixon 2006 {published data only}
    1. Dixon AJ, Dixon MP, Dixon JB. Randomized clinical trial of the effect of applying ointment to surgical wounds before occlusive dressing. British Journal of Surgery 2006;93:937‐43.
Dobbelaere 2015 {published data only}
    1. Dobbelaere A, Schuermans N, Smet S, Straeten C, Victor J. Comparative study of innovative postoperative wound dressings after total knee arthroplasty. Acta Orthopedia Belgium 2015;81:454‐61.
Dosseh Ekoue 2008 {published data only}
    1. Dosseh Ekoue D, Doleaglenou A, Fortey YK, Ayite AE. Randomized trial comparing dressing to no dressing of surgical wounds in a tropical setting [Pansement versus absence de pansement au‐delà de 48 heures en milieu tropical: essai randomisé]. Journal de Chirurgie 2008;145(2):143–6.
Edwards 1967 {published data only}
    1. Edwards RH, Killen DA. Comparison of two methods of management of clean surgical wounds. JAMA 1967;201(1):137‐8.
Eymann 2010 {published data only}
    1. Eymann R, Kiefer M. Glue instead of stitches: a minor change of the operative technique with a serious impact on the shunt infection rate. Acta Neurochirurgica. Supplement 2010;106:87‐9.
Fries 2014 {published data only}
    1. Fries CA, Ayalew Y, Penn‐Barwell JG, Porter K, Jeffery SL, Midwinter MJ. Prospective randomised controlled trial of nanocrystalline silver dressing versus plain gauze as the initial post‐debridement management of military wounds on wound microbiology and healing. Injury 2014;45:1111‐6.
Furrer 1993 {published data only}
    1. Furrer M, Inderbitzi R, Nachbur B. Does administration of fibrin glue prevent development of lymphoceles after radical lymphadenectomy?. Der Chirurg 1993;64(12):1044‐9.
Garne 1989 {published data only}
    1. Garne E, Merrild DB. Wound Infection following heart surgery. Ugeskrift for Laeger 1989;151:2192–3.
Gbolahan 2015 {published data only}
    1. Gbolahan OO, Ogunmuyiwa SA, Osinaike BB. Randomized controlled trial comparing dressing and no dressing of surgical wound after cleft lip repair. American Journal of Critical Care 2015;16:554‐8.
Giri 2004 {published data only}
    1. Giri P, Kanti Das M, Majumdar A. Management of different types of wound by cyanoacrylate glue fixation: a random study of 213 patients. Journal of the Indian Medical Association 2004;102(11):625‐6.
Gonzalez 2002 {published data only}
    1. Gonzalez Llinares RM, Antolin Mugarza A, Salgado Larrea MV, Barandiaran Mugica MJ, Basurco Celaya R, Larranaga Garaikaoetxea N. Effectiveness of dressings in clean and clean‐contaminated surgical wounds 24‐48 hours after surgery. Enfermeria Clinica 2002;2:117‐21.
Grauhan 2010 {published data only}
    1. Grauhan O, Navasardyan A, Hofmann M, Muller P, Hummel M, Hetzer R. Cyanoacrylate‐sealed Donati suture for wound closure after cardiac surgery in obese patients. Interactive Cardiovascular and Thoracic Surgery 2010;11(6):763‐7.
Grover 2015 {published data only}
    1. Grover A, Singh A, Sidhu DS. A prospective randomised trial of open wound treatment vs occlusive dressings in elective surgical cases with respect to surgical site infections. Journal of Clinical and Diagnostic Research 2015;9:PC26‐9.
Guilbaud 1993 {published data only}
    1. Guilbaud J, Honde C. Multicentre comparative clinical study of a new wound dressing: PA286 (Inerpan). European Journal of Plastic Surgery. 1993;16(2):73‐6.
Guillotreau 1996 {published data only}
    1. Guillotreau J, Flandrin Andre P, Moncade F. Calcium alginate and povidone iodine packs in the management of infected postoperative wounds: results of a randomized study [abstract]. British Journal of Surgery 1996;83:86.
Gupta 1991 {published data only}
    1. Gupta R, Foster ME, Miller E. Calcium alginate in the management of acute surgical wounds and abscesses. Journal of Tissue Viability 1991;1(4):115‐6.
Heal 2009 {published data only}
    1. Heal CF, Buettner PG, Cruickshank R, Graham D, Browning S, Pendergast J, et al. Does single application of topical chloramphenicol to high risk sutured wounds reduce incidence of wound infection after minor surgery? Prospective randomised placebo controlled double blind trial. BMJ 2009;338:a2812. [DOI: 10.1136/bmj.a2812]
Hermans 2000 {published data only}
    1. Hermans M. A prospective clinical trial of wound dressings to investigate the rate of infection under occlusion. First World Wound Healing Congress, 2000 September 10‐13; Melbourne, Australia. 2000:92.
Hirose 2002 {published data only}
    1. Hirose T, Takahashi S, Shimizu T, Nishiyama N, Furuya R, Takeyama K, et al. Clinical and bacteriological outcomes of post‐operative surgical sites with and without antisepsis in the field of urology. Dermatology 2002;204(Suppl 1):122.
Hutchinson 1997 {published data only}
    1. Hutchinson J. Prospective study of clinical infections in wounds dressed with hydrocolloid versus conventional dressings. Proceedings of the sixth European Conference on Advances in Wound Management, 1996 October 1‐4; Amsterdam, the Netherlands. Amsterdam, 1997:263.
Igarza 1997 {unpublished data only}
    1. Igarza JL, Conejo JS. A clinical and microbiological evaluation of dressings in dermatological surgery: adhesive strips compared with a thin hydrocolloid. Sixth European Conference on Advances in Wound Management, 1995 November 21‐24; Harrogate, UK. 1995.
Johannesson 2008 {published data only}
    1. Johannesson A, Larsson GU, Oberg T, Atroshi I. Comparison of vacuum‐formed removable rigid dressing with conventional rigid dressing after transtibial amputation: similar outcome in a randomized controlled trial involving 27 patients. Acta Orthopaedica 2008;79 (3):361‐9.
Juergens 2011 {published data only}
    1. Juergens S, Maune C, Kezze F, Mohr T, Scheuer K, Mallman P. A randomized, controlled study comparing the cosmetic outcome of a new wound closure device with prolene suture closing caesarean wounds. Internation Wound Journal 2011;8:329‐35.
Kadar 2015 {published data only}
    1. Kadar A, Eisenberg G, Yahav E, Drexler M, Salai M, Steinberg EL. Surgical site infection in elderly patients with hip fractures, silver‐coated versus regular dressings: a randomised prospective trial. Journal of Wound Care 2015;24:441‐2,444‐5.
Kiefer 2016 {published data only}
    1. Kiefer DG, Muscat JC, Santorelli J, Chavez MR, Ananth CV, Smulian JC, et al. Effectiveness and short‐term safety of modified sodium hyaluronic acid‐carboxymethylcellulose at cesarean delivery: a randomized trial. American Journal of Obstetrics and Gynecology 2016;214:e1‐373.
Lambiris 1979 {published data only}
    1. Lambiris E, Friedebold G, Zilch H. Local treatment of surgical infections using PMMA‐spheres and chains ‐ results from Berlin. Aktuelle Probleme in Chirurgie und Orthopadie 1979;12:161‐9.
Mandy 1985 {published data only}
    1. Mandy SH. Evaluation of a new povidine‐iodine impregnated polyethylene oxide gel occlusive dressing. Journal of the American Academy of Dermatology 1985;13(4):655‐9.
Marinovic 2010 {published data only}
    1. Marinović M, Cicvarić T, Juretić I, Grzalja N, Medved I, Ahel J. Application of wound closure Molndal technique after laparoscopic cholecystectomy‐initial comparative study. Collegium Antropologicum 2010;34(Suppl 2):243‐5.
Martin‐Garcia 2005 {published data only}
    1. Martin‐Garcia RF, Janer AL, Rullan FV. Octyl‐2‐cyanoacrylate liquid bandage as a wound dressing in facial excisional surgery: results of an uncontrolled pilot study. Dermatologic Surgery 2005;31:670‐3.
Maw 1997 {published data only}
    1. Maw I, Quinn J, Wells G, Ducic Y, Odell P, Lamothe A, et al. A prospective comparison of octylcyanoacrylate tissue adhesive and suture for the closure of head and neck incisions. The Journal of Otolaryngology 1997;26:26‐30.
McVeigh 2011 {published data only}
    1. McVeigh T, Kovacic D, Tawfick W, Sultan S. Assessing the impact of techniques of wound closure on vascular surgical site infection rates. Irish Journal of Medical Science: Sylvester O'Halloran Meeting. 2011:S114.
Merei 2004 {published data only}
    1. Merei JM. Pediatric clean surgical wounds: is dressing necessary?. Journal of Pediatric Surgery 2004;39(12):1871‐3.
Meylan 2001 {published data only}
    1. Meylan G, Tschantz P. Surgical wounds with or without dressing. Prospective comparative study [Pansement ou absence de pansement sur les plaies operatoires. Etude prospective comparative]. Annales de Chirurgie 2001;126(5):459‐62.
Milne 1999 {published data only}
    1. Milne CT, Pierpont Barrere CC, McLaughlin T, Moore A. Surgical hip dressings: a comparison of taping methods. Orthopedic Nursing 1999;18(3):37‐42.
Moore 1997 {unpublished data only}
    1. Moore P, Foster L. The use of a hydrofibre dressings in surgical wounds. European Wound Management Association Conference, 1997 April 27‐29; Milan, Italy. 1997:42‐4.
Morales 2006 {published data only}
    1. Morales Moreira E, Jesus Hernandez M, Granados Hernandez D, Sardinas Lopez G. Use of tisuacryl as tissue adhesive in the healing of cutaneous facial wounds and those of the buccal mucosa [Empleo del Tisuacryl como adhesivo tisular en el cierre de heridas faciales cutáneas y de la mucosa bucal]. Mediciego 2006;12:Available from .
Müller 1993 {unpublished data only}
    1. Müller K, Matzen E, Gottrup F. Treatment of incisional wound defects following laparotomy, in relation to treatment effect, time consumption and economy. A methodological description. Third European Conference on Advances in Wound Management, 1993 October 19‐22; Harrogate, UK. 1993.
Nearuy 2000 {unpublished data only}
    1. Nearuy PC, Watson G, Andriessen A. A randomised comparative evaluation of a hydrogel vs paraffin gauze in the management of surgical wounds. First World Wound Healing Congress, 2000 September 10‐13; Melbourne, Australia. 2000.
Palao i Domenech 2008 {published data only}
    1. Palao i Domenech R, Romanelli M, Tsiftsis DD, Slonkova V, Jortikka A, Johannesen N, et al. Effect of an ibuprofen‐releasing foam dressing on wound pain: a real‐life RCT. Journal of Wound Care 2008;17(8):342,344‐8.
Palao i Domenech 2009 {published data only}
    1. Palao i Domenech R, Prantl L, Larsen AM, Jortikka A. Effects of a foam dressing with ibuprofen on wound pain in acute wounds. European Wound Manangement Association Journal 2009;9(2):102, Abstract P6.
Parvizi 2013 {published data only}
    1. Parvizi D, Friedl H, Schintler MV, Rappl T, Laback C, Wiedner M, et al. Use of 2‐octyl cyanoacrylate together with a self‐adhering mesh (DermabondTM PrineoTM) for skin closure following abdominoplasty: an open, prospective, controlled, randomized, clinical study. Aesthetic Plastic Surgery 2013;37:529‐37.
Pastorfide 1989 {published data only}
    1. Pastorfide GB, Gorgonio NM, Ganzon AR, Alberto RM. Zinc chloride spray‐magnesium hydroxide ointment dual topical regimen in the treatment of obstetric and gynecologic incisional wounds. Clinical Therapeutics 1989;11(2):258‐63.
Piromchai 2008 {published data only}
    1. Piromchai P, Vatanasapt P, Reechaipichitkul W, Phuttharak W, Thanaviratananich S. Is the routine pressure dressing after thyroidectomy necessary? A prospective randomized controlled study. BMC Ear, Nose and Throat Disorders 2008;8:1.
Pizarro Sule 2001 {published data only}
    1. Pizarro Sule C, Silva Orrego V, Ordenes VM, Bozinovic AF, Cabezas MJ. Management of surgical wounds with occlusive dressings [Manejo de herida operatoria con aposito oclusivo]. Revista Chilena de Cirugía 2001;53:386‐9.
Ponnighaus 1999 {published data only}
    1. Ponnighaus JM, Kowalzick L. Polyurethane or calcium alginate dressings for temporary defects in tumour surgery?. Aktuelle Dermatologie 1999;25(5):133‐5.
Ravenscroft 2006 {published data only}
    1. Ravenscroft MJ, Harker J, Buch KA. A prospective, randomised, controlled trial comparing wound dressings used in hip and knee surgery: Aquacel and Tegaderm versus Cutiplast. Annals of the Royal Collage of Surgeons of England 2006;88(1):18‐22.
Reinicke 1990 {published data only}
    1. Reinicke G, Nowak W, Adler KP. Does the elastic wound‐dressing Ankerplast spray influence the healing process of wounds? [Beeinflusst der elastische Wundschnellverband Ankerplast‐Spray die Wundheilung?]. Experimentelle Chirurgie 1990;115:111‐6.
Ridley 2016 {published data only}
    1. Ridley N. An audit and trial aiming to reduce the rate of surgical site infections for women having a caesarean section. British Journal of Midwifery 2016;24:170‐1.
Robson 2012 {published data only}
    1. Robson V, Yorke J, Sen RA, Lowe D, Rogers SN. Randomised controlled feasibility trial on the use of medical grade honey following microvascular free tissue transfer to reduce the incidence of wound infection. British Journal of Oral and Maxillofacial Surgery 2012;50:321‐7.
Romero 2011 {published data only}
    1. Romero P, Frongia G, Wingerter S, Holland‐Cunz S. Prospective, randomized, controlled trial comparing a tissue adhesive (Dermabond) with adhesive strips (Steri‐Strips) for the closure of laparoscopic trocar wounds in children. European Journal of Pediatric Surgery 2011;21(3):159‐62.
Rosenfeldt 2003 {published data only}
    1. Rosenfeldt FL, Negri J, Holdaway D, Davis BB, Mack J, Grigg MJ, et al. Occlusive wrap dressing reduces infection rate in saphenous vein harvest site. Annals of Thoracic Surgery 2003;75(1):101‐5.
Rushbrook 2014 {published data only}
    1. Rushbrook JL, White G, Kidger L, Marsh P, Taggart TF. The antibacterial effect of 2‐octyl cyanoacrylate (Dermabond) skin adhesive. Journal of Infection Prevention 2014;15:236‐9.
Schwartz 2014 {published data only}
    1. Schwartz J, Goss S, Facchin F, Manizate F, Gendics C, Braitman E, et al. A prospective two‐armed trial assessing the efficacy and performance of a silver dressing used postoperatively on high‐risk, clean surgical wounds. Ostomy Wound Management 2014;60:30‐40.
Segers 2007 {published data only}
    1. Segers P, Jong AP, Spanjaard L, Ubbink DT, Mol BA. Randomized clinical trial comparing two options for postoperative incisional care to prevent post‐sternotomy surgical site infections. Wound Repair and Regeneration 2007;15(2):192–6.
Shamiyeh 2001 {published data only}
    1. Shamiyeh A, Schrenk P, Stelzer T, Wayand WU. Prospective randomised blind controlled trial comparing sutures, tape, and octylcyanoacrylate tissue adhesive for skin closure after phlebectomy. Dermatologic Surgery 2001;27:877‐80.
Sheppard 2014 {published data only}
    1. Sheppard C, Kent WD, Fedak P. Negative pressure dressing to decrease the incidence of leg wound complications after CABG: nursing perspectives for patient care. Canadian Journal of Cardiology 2014;30(10):S354.
Shima 1998 {published data only}
    1. Shima Y. Clinical efficacy of thin hydrocolloid dressing (KYD) for healing of surgical wound. Rinsho to Kenkyu (The Japanese Journal of Clinical and Experimental Medicine) 1998;75:669‐79.
Signorini 2007 {published data only}
    1. Signorini M, Clementoni MT. Clinical evaluation of a new self‐drying silicone gel in the treatment of scars: a preliminary report. Aesthetic Plastic Surgery 2007;31(2):183‐7.
Singer 2002 {published data only}
    1. Singer AJ, Quinn JV, Hollander JE. Comparison of octylcyanoacrylate and standard wound closure methods for lacerations and Incisions: a multi‐center trial. Academic Emergency Medicine 2002;131:270‐6.
Sinha 2001 {published data only}
    1. Sinha S, Naik M, Wright V, Timmons J, Campbell AC. A single blind, prospective, randomised trial comparing n‐butyl 2‐cyanoacrylate tissue adhesive (Indermil) and sutures for skin closure in hand surgery. Journal of Hand Surgery 2001;26B:264‐5.
Slawson 2002 {published data only}
    1. Slawson D. How does laceration and incision repair with the tissue adhesive octylcyanoacrylate (Dermabond) compare with standard wound closure methods?. Surgery 2002;5:2.
Sondergaard 1982 {published data only}
    1. Sondergaard JO, Galatius H. Debrisan compared with chloramine packs in the treatment of postoperative wounds. Ugeskrift for Laeger 1982;144(21):1523‐5.
Stanirowski 2016a {published data only}
    1. Stanirowski PJ, Kociszewska A, Cendrowski K, Sawicki W. Dialkylcarbamoyl chloride‐impregnated dressing for the prevention of surgical site infection in women undergoing cesarean section: a pilot study. Archives of Medical Science 2016;12:1‐7.
Stanirowski 2016b {published data only}
    1. Stanirowski PJ, Bizon M, Cendrowski K, Sawicki W. Randomized controlled trial evaluating dialkylcarbamoyl chloride impregnated dressings for the prevention of surgical site infections in adult women undergoing cesarean section. Surgical Infections 2016;7:427‐35.
Staveski 2013 {published data only}
    1. Staveski S, Abrajano C, Casazza M, Dong E, Petty A, Felix K, et al. Silver dressings for sternotomy incision care in pediatric cardiac patients to decrease surgical site infections. Pediatric Critical Care Medicine 2013;14(Suppl 1):S97.
Staveski 2016 {published data only}
    1. Staveski S, Abrajano C, Casazza M, Bair E, Quan H, Dong E, et al. Silver‐Impregnated dressings for sternotomy incisions to prevent surgical site infections in children. American Journal of Critical Care 2016;25:402‐8.
Terrill 2000 {published data only}
    1. Terrill PJ, Varughese G. A comparison of three primary non‐adherent dressings applied to hand surgery wounds. Journal of Wound Care 2000;9(8):359‐63.
Teshima 2009 {published data only}
    1. Teshima H, Kawano H, Kashikie H, Nakamura K, Imada T, Oda T, et al. A new hydrocolloid dressing prevents surgical site infection of median sternotomy wounds. Surgery Today 2009;39(1):848‐54.
Tofuku 2012 {published data only}
    1. Tofuku K, Koga H, Yanase M, Komiya S. The use of antibiotic‐impregnated fibrin sealant for the prevention of surgical site infection associated with spinal instrumentation. European Spine Journal 2012;21:2027‐33.
Torra i Bou 2013 {published data only}
    1. Torra i Bou JE, Abejon Arroyo A, Garcia Veira M, Cabero Garcia B, Gonzalez Carbjose MJ, Garcis Caridad L, et al. Clinical comparison of a film surgical dressing versus gauze tape dressing in the management of post‐operative surgical wounds in orthopedic surgery patients. European Wound Management Association Journal 2013;13(Suppl 167):Abstract 277.
Ubbink 2008 {published data only}
    1. Ubbink DT, Vermeulen H, Goossens A, Kelner RB, Schreuder SM, Lubbers MJ. Occlusive vs gauze dressings for local wound care in surgical patients: a randomized clinical trial. Archives of Surgery 2008;143(10):950‐5.
    1. Ubbink DT, Vermeulen H, Goossens A . Modern versus gauze dressings to treat open wounds in surgical patients: a randomised clinical trial. Australian Wound Management Association Seventh National Conference: Dreams, Diversity, Disasters, 2008 May 7‐10; Darwin, Australia. 2008.
Valente 2008 {published data only}
    1. Valente M, Patricio A, Sousa A, Brilhante F. The Molndal technique: a comparative assessment. European Wound Management Association Journal 2008;2(Suppl 2):Abstract P194.
Widgerow 2009 {published data only}
    1. Widgerow AD, Chait LA, Stals PJ, Stals R, Candy G. Multimodality scar management program. Aesthetic Plastic Surgery 2009;33(4):533‐43.
Wipke‐Tevis 1993 {unpublished data only}
    1. Wipke‐Tevis D, Stotts NA. Dressings, cosmetic result, pain, distress and wound healing of surgical incisions. First Joint Meeting of the Wound Healing Society and the European Tissue Repair Society, 1993 August 22‐25; Amsterdam, the Netherlands. 1993.
Wipke‐Tevis 1998 {published data only}
    1. Wipke‐Tevis DD, Stotts NA. Effect of dressings on saphenous vein harvest incision pain, distress and cosmetic result. Progress in Cardiovascular Nursing 1998;13(3):3‐13.
Yamanaka 2012 {published data only}
    1. Yamanaka N, Tanaka M. Examination of film material suitable for wound management after abdominal surgery. Fourth Congress of the World Union of Wound Healing Societies, 2012 September 2‐6; Yokohama, Japan. 2012.
Yang 2013 {published data only}
    1. Yang X, Zhou H‐F, Zhang S‐M, Wang Y‐Z, Ye N, Wang Y, et al. Hydrofiber dressing with silver in wound healing after surgery for anal fistula. Chinese Journal of Tissue Engineering Research 2013;16:8835‐41.
References to studies awaiting assessment Goharshenasan 2016 {published data only}
    1. Goharshenasan P, Amini S, Atria A, Abtahi H, Khorasani G. Topical application of honey on surgical wounds: a randomized clinical trial. Forschende Komplementarmedizin 2016;23:12‐5.
Siddiqui 2016 {published data only}
    1. Siddiqui M, Bidaye A, Baird E, Abu‐Rajab R, Stark A, Jones B, et al. Wound dressing following primary total hip arthroplasty: a prospective randomised controlled trial. Journal of Wound Care 2016;40:42‐5.
    1. Siddiqui M, Bidaye A, Baird E, Jones B, Stark A, Abu‐Rajab R, et al. Wound closure following primary total hip arthroplasty. Tenth Congress of the European Hip Society, 2012 September 20‐22; Milan, Italy. Milan, Italy: Wichtig Publishing Srl, 2012:425.
Springer 2015 {published data only}
    1. Springer BD, Beaver WB, Griffin WL. The role of surgical dressings in total knee arthroplasty: a randomized clinical trial. Current Orthopaedic Practice 2013;24(4):452‐3.
    1. Springer BD, Beaver WB, Griffin WL, Mason JB, Odum SM. Role of surgical dressings in total joint arthroplasty: a randomized controlled trial. American Journal of Orthopedics 2015;44:415‐20.
References to ongoing studies ISRCTN06792113 {published data only}
    1. ISRCTN06792113. The Bluebelle Study: complex, simple and absent wound dressings in elective surgery: Phase A. (first received 18 March 2014).
NCT02619773 {published data only}
    1. NCT02619773. Effect of mupirocin dressings versus island dressings on surgical site infections in elective colorectal surgery. (first received 30 November 2015).
NCT02771015 {published data only}
    1. NCT02771015. Performance of flexible self‐adherent absorbent dressing coated with a soft silicone layer after hip‐, knee‐arthroplasty, primary spine surgery in comparison to a standard wound dressing (wound dressing). (first received 8 September 2015).
NCT02904200 {published data only}
    1. NCT02904200. Clinical investigation of two different wound dressings. (first received 13 September 2016).
Additional references Allegranzi 2016
    1. Allegranzi B, Zayed B, Bischoff P, Kubilay NZ, Jonge S, Vries F, et al. New WHO recommendations on intraoperative and postoperative measures for surgical site infection prevention: an evidence‐based global perspective. Lancet Infectious Diseases 2016;S1473‐3099:30402‐9 [Epub ahead of print].
Astagneau 2009
    1. Astagneau P, L'Hériteau F, Daniel F, Parneix P, Venier AG, Malavaud S, et al. Reducing surgical site infection incidence through a network: results from the French ISO‐RAISIN surveillance system. Journal of Hospital Infection 2009;72(2):127‐34.
BNF 2016
    1. British Medical Association and Royal Pharmaceutical Society of Great Britain. British National Formulary (BNF): Appendix 5: wound management products and elasticated garments. (accessed 4 November 2016).
Bruce 2001
    1. Bruce J, Russell EM, Mollison J, Krukowski ZH. The measurement and monitoring of surgical adverse events. Health Technology Assessment Monograph 2001;5(22):1‐194.
Button 2010
    1. Button KS, Ioannidis JP, Mokrysz C, Nosek BA, Flint J, Robinson ES, et al. Power failure: why small sample size undermines the reliability of neuroscience. Nature Reviews Neuroscience 2010;14:365‐76.
de Lissovoy 2009
    1. Lissovoy G, Fraeman K, Hutchins V, Murphy D, Song D, Vaughn BB. Surgical site infection: incidence and impact on hospital utilization and treatment costs. American Journal of Infection Control 2009;37(5):387‐97.
Deeks 2002
    1. Deeks JJ. Issues in the selection of a summary statistic for meta‐analysis of clinical trials with binary outcomes. Statistics in Medicine 2002;21:1575‐600.
Deeks 2011
    1. Deeks JJ, Higgins JP, Altman DG, on behalf of the Cochrane Statistical Methods Group. Chapter 9: Analysing data and undertaking meta‐analyses. In: Higgins JP, Green S, editor(s). Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0 (updated March 2011). The Cochrane Collaboration, 2011. Available from .
Gibbons 2011
    1. Gibbons C, Bruce J, Carpenter J, Wilson AP, Wilson J, Pearson A, et al. Identification of risk factors by systematic review and development of risk‐adjusted models for surgical site infection. Health Technology Assessment 2011;15(30):1‐156.
Goldman 1992
    1. Goldman MP, Fronek A. Consensus paper on venous leg ulcer. Journal of Dermatology Surgery and Oncology 1992;18:592‐602.
GRADE 2013
    1. Schünemann H, Brożek J, Guyatt G, Oxman A, editor(s), GRADE working group. GRADE Handbook. (accessed 5 February 2016).
Health Protection Agency 2002
    1. Health Protection Agency. Surveillance of surgical site infection in English hospitals 1997‐2002. A national surveillance and quality improvement programme. London (UK): Health Protection Agency, 2002.
Higgins 2003
    1. Higgins JP, Thompson SG, Deeks JJ, Altman DG. Measuring inconsistency in meta‐analyses. BMJ 2003;327(7414):557‐60.
Higgins 2011
    1. Higgins JP, Green S, editor(s). Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0 (updated March 2011). The Cochrane Collaboration, 2011. Available from .
Horan 2008
    1. Horan TC, Andrus M, Dudeck MA. DC/NHSN surveillance definition of healthcare‐associated infection and criteria for specific types of infections in the acute care setting. American Journal of Infection Control 2008;36(5):309‐32.
Hróbjartsson 2012
    1. Hróbjartsson A, Thomsen AS, Emanuelsson F, Tendal B, Hilden J, Boutron I, et al. Observer bias in randomised clinical trials with binary outcomes: systematic review of trials with both blinded and non‐blinded outcome assessors. BMJ 2012;344:e1119.
Lefebvre 2011
    1. Lefebvre C, Manheimer E, Glanville J. Chapter 6: Searching for studies. In: Higgins JP, Green S, editor(s). Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0 (updated March 2011). The Cochrane Collaboration, 2011. Available from .
McLaws 2000
    1. McLaws ML, Murphy C, Whitby M. Standardising surveillance of nosocomial infections: the HISS program. Hospital Infection Standardised Surveillance. Journal of Quality in Clinical Practice 2000;20(1):6–11.
NICE 2008
    1. National Institute of Health and Care Excellence (NICE). Surgical site infections: prevention and treatment. Clinical guideline [CG74]. October 2008. (accessed 4 November 2016).
Plowman 2001
    1. Plowman R, Graves N, Griffin MA, Roberts JA, Swan AV, Cookson B, et al. The rate and cost of hospital‐acquired infections occurring in patients admitted to selected specialties of a district general hospital in England and the national burden imposed. Journal of Hospital Infection 2001;47(3):198‐209.
RevMan 2014 [Computer program]
    1. The Nordic Cochrane Centre, The Cochrane Collaboration. Review Manager (RevMan). Version 5.3. Copenhagen: The Nordic Cochrane Centre, The Cochrane Collaboration, 2014.
Schulz 2010
    1. Schulz KF, Altman DG, Moher D, CONSORT Group. CONSORT 2010 statement: updated guidelines for reporting parallel group randomised trials. PLOS Med 2010;7:e1000251.
Schünemann 2011a
    1. Schünemann HJ, Oxman AD, Higgins JP, Deeks JJ, Glasziou P, Guyatt GH. Chapter 12: Interpreting results and drawing conclusions. In: Higgins JP, Green S, editor(s). Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0 (updated March 2011). The Cochrane Collaboration, 2011. Available from .
Schünemann 2011b
    1. Schünemann HJ, Oxman AD, Higgins JP, Vist GE, Glasziou P, Guyatt GH. Chapter 11: Presenting results and 'Summary of findings' tables. In: Higgins JP, Green S, editor(s). Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0 (updated March 2011). The Cochrane Collaboration, 2011. Available from .
SIGN 2015
    1. Scottish Intercollegiate Guidelines Network (SIGN). Search filters. (accessed 4 November 2016).
Smyth 2008
    1. Smyth ET, McIlvenny G, Enstone JE, Emmerson AM, Humphreys H, Fitzpatrick F, et al. Four country healthcare associated infection prevalence survey 2006: overview of the results. Journal of Hospital Infection 2008;69(3):230‐48.
Sterne 2011
    1. Sterne JA, Egger M, Moher D. Chapter 10: Addressing reporting biases. In: Higgins JP, Green S, editor(s). Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0 (updated March 2011). The Cochrane Collaboration, 2011. Available from .
References to other published versions of this review Walter 2012
    1. Walter CJ, Dumville JC, Sharp CA, Page T. Systematic review and meta‐analysis of wound dressings in the prevention of surgical‐site infections in surgical wounds healing by primary intention. British Journal of Surgery 2012;9(9):1185‐1194.

Source: PubMed

Sponsors and Collaborators

Medical Conditions

Drug Interventions

3
Subscribe