title: Meta-analysis of local gentamicin for prophylaxis of surgical site infections in colorectal surgery.
abstract: OBJECTIVE
  Surgical site infections (SSIs) following colorectal surgery is common, and local application of gentamicin for SSIs in the surgery remains controversial.
  
  
  OBJECTIVE
  To identify whether local application of gentamicin reduces incidence of SSIs in colorectal surgery.
  
  
  METHODS
  PubMed, Embase, the Cochrane Library, and Science Citation Index were searched for relevant randomized controlled trials (RCTs) and reference list up to November 2014. Two independent reviewers screened the records from the electronic databases, selected relevant studies, assessed the methodological quality, and extracted the data from included articles. Stata 12.0 was used to conduct a pooled analysis for main outcomes.
  
  
  RESULTS
  Eight relevant randomized controlled trials with a total of 1685 patients were included in the meta-analysis. All included studies were of moderate to high quality by the Cochrane Collaboration's tool for assessing risk of bias. There was no significant difference being found in the total pooled results for wound infection (relative risk (RR) 0.73, 95% confidence interval (CI) 0.47 to 1.12) and organ space infection (RR 0.90, 95% CI 0.51 to 1.59). However, subgroup analysis showed that the significant decrease of wound infection was associated with the population in the Western Europe (RR 0.60, 95% CI 0.42 to 0.87) and follow-up periods of 30 days (RR 0.63, 95% CI 0.42 to 0.94).
  
  
  CONCLUSIONS
  Local application of gentamicin significantly reduced incidence of wound infection following colorectal surgery in Western Europe, and it was also associated with lower risk of wound infection during follow-up period of 30 days. However, its effectiveness on prophylaxis of perineal wound infection and organ space infection still lacked evidence.
authors.affiliation: Shandong University of Traditional Chinese Medicine, 16369 Jingshi Road, Lixia District, Jinan, Shandong, 250014, People's Republic of China.
authors.forename: Yan-Fei
authors.initials: YF
authors.lastname: Lv
authors.affiliation: Shandong University of Traditional Chinese Medicine, 16369 Jingshi Road, Lixia District, Jinan, Shandong, 250014, People's Republic of China.
authors.forename: Jian
authors.initials: J
authors.lastname: Wang
authors.affiliation: Shandong Airlines Co., Ltd, Yaoqiang International Airport, Jinan, Shandong, 250107, People's Republic of China.
authors.forename: Feng
authors.initials: F
authors.lastname: Dong
authors.affiliation: Shandong University of Traditional Chinese Medicine, 16369 Jingshi Road, Lixia District, Jinan, Shandong, 250014, People's Republic of China. misiss5@163.com.
authors.forename: Dian-Hui
authors.initials: DH
authors.lastname: Yang
mesh_terms: D000287:Administration, Topical; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D003108:Colonic Diseases / Q000601:surgery*; D015179:Colorectal Neoplasms / Q000601:surgery; D005839:Gentamicins / Q000627:therapeutic use*; D006801:Humans; D012002:Rectal Diseases / Q000601:surgery*; D013530:Surgical Wound Infection / Q000517:prevention & control*
chemical_list: D000900:Anti-Bacterial Agents; D005839:Gentamicins
keywords: Collagen-gentamicin sponge; Colorectal surgery; Local gentamicin; Surgical site infection