title: Effectiveness of a gentamicin impregnated collagen sponge on reducing sternal wound infections following cardiac surgery: a meta-analysis of randomised controlled trials.
abstract: BACKGROUND
  Gentamicin impregnated collagen sponges are licensed for use after cardiac surgery in over 50 countries but their effectiveness at preventing sternal wound infections (SWIs) remains uncertain. The aim of this meta-analysis was to assess the current evidence for effectiveness of such sponges at preventing SWIs in patients after cardiac surgery.
  
  
  METHODS
  A systematic search of the literature was undertaken and meta-analyses were performed on the results of the identified, eligible studies. Using random effects models, odds ratios (OR) and corresponding 95% confidence intervals (CI) were calculated for all SWIs and deep SWIs for: a) all participants, and b) participants deemed as high risk.
  
  
  RESULTS
  Three unique randomised controlled trials (published between 2005 and 2010) involving 3,994 participants met the inclusion criteria. There was insufficient evidence of a significant difference between intervention and control groups for all SWIs (all participants: OR: 0.66, 95% CI: 0.39-1.14; high risk participants: OR: 0.60, 95% CI: 0.24-1.52). There was insufficient evidence of a significant benefit of the sponge in deep SWIs across all participants (OR: 0.72, 95% CI: 0.47-1.10) but some evidence of benefit in terms of reducing the incidence of deep SWIs in high risk participants (OR: 0.62, 95% CI: 0.39-0.98).
  
  
  CONCLUSIONS
  There is insufficient evidence of the effectiveness (or otherwise) of gentamicin impregnated sponges in preventing SWIs following cardiac surgery. However, some evidence does exist that such sponges can reduce the incidence of deep infections in high risk patients.
authors.affiliation: Centre for Health and Environmental Statistics, Plymouth University, UK. siobhan.creanor@plymouth.ac.uk
authors.forename: S
authors.initials: S
authors.lastname: Creanor
authors.forename: A
authors.initials: A
authors.lastname: Barton
authors.forename: A
authors.initials: A
authors.lastname: Marchbank
mesh_terms: D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D006348:Cardiac Surgical Procedures / Q000379:methods*; D003094:Collagen / Q000627:therapeutic use*; D005839:Gentamicins / Q000008:administration & dosage*; D006801:Humans; D016032:Randomized Controlled Trials as Topic; D012307:Risk Factors; D013249:Sternum; D015503:Surgical Sponges; D013530:Surgical Wound Infection / Q000517:prevention & control*; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents; D005839:Gentamicins; D003094:Collagen