title: Gentamicin collagen sponges for the prevention of sternal wound infection: a meta-analysis of randomized controlled trials.
abstract: OBJECTIVE
  The study objective was to determine whether the application of gentamicin collagen sponges reduces sternal wound infections in patients undergoing cardiac surgery.
  
  
  METHODS
  A meta-analysis of randomized controlled trials was performed.
  
  
  RESULTS
  Four randomized controlled trials were eligible for inclusion. By pooling data from 4 randomized controlled trials (4672 per-protocol patients), gentamicin collagen sponges reduced deep sternal wound infections (risk ratio, 0.62; 95% confidence interval, 0.39-0.97) and any sternal wound infections (risk ratio, 0.61; confidence interval, 0.39-0.98). In contrast, no benefit was demonstrated regarding superficial sternal wound infections (4 randomized controlled trials [4672 patients]; risk ratio, 0.65; 95% confidence interval, 0.34-1.25) and all-cause mortality (3 randomized controlled trials [3994 patients]; risk ratio, 0.90; 95% confidence interval, 0.57-1.42). On the basis of data from 2 randomized controlled trials (3410 patients), gentamicin collagen sponges also seemed to reduce surgically treated sternal wound infections (risk ratio, 0.59; 95% confidence interval, 0.41-0.86). The most commonly isolated pathogens were coagulase-negative Staphylococcus spp (43%) and Staphylococcus aureus (28%).
  
  
  CONCLUSIONS
  Gentamicin collagen sponges seem to reduce the sternal wound infection rate in patients undergoing cardiac surgery. The statistical heterogeneity among the existing trials underlines the need for additional large, high-quality randomized controlled trials.
authors: Alfa Institute of Biomedical Sciences, Athens, Greece.
authors: Michael N
authors: MN
authors: Mavros
authors: Pantelis K
authors: PK
authors: Mitsikostas
authors: Vangelis G
authors: VG
authors: Alexiou
authors: George
authors: G
authors: Peppas
authors: Matthew E
authors: ME
authors: Falagas
mesh_terms: D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D006348:Cardiac Surgical Procedures / Q000009:adverse effects*; D016009:Chi-Square Distribution; D003094:Collagen; D019317:Evidence-Based Medicine; D005839:Gentamicins / Q000008:administration & dosage*; D006801:Humans; D016017:Odds Ratio; D016032:Randomized Controlled Trials as Topic; D018570:Risk Assessment; D012307:Risk Factors; D056346:Sternotomy / Q000009:adverse effects*; D015503:Surgical Sponges; D013530:Surgical Wound Infection / Q000382:microbiology / Q000517:prevention & control*; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents; D005839:Gentamicins; D003094:Collagen