title: Gentamicin-Collagen Sponges for the Prevention of Surgical Site Infections: A Meta-Analysis of Randomized Controlled Trials.
abstract: BACKGROUND
  To study the effectiveness of gentamicin-collagen sponges (GCS) for the prevention of surgical site infections (SSIs).
  
  
  METHODS
  A systematic search of the PubMed and Scopus databases was performed (up to April 2015) to identify randomized controlled trials evaluating the efficacy of GCS for the prevention of SSIs. A random effects model was applied.
  
  
  RESULTS
  Twenty-one RCTs (8,472 patients) were included. Gentamicin-collagen sponges were associated with a lower risk of SSIs (risk ratio [RR] 0.65; 95% confidence interval [CI] 0.49-0.84). Based on Jadad scores, a lower risk for the development of SSI was presented in lower-quality studies (Jadad <3; RR 0.44; 95% CI 0.27-0.71), but no difference was observed in high-quality studies (Jadad ≥3; RR 0.77; 95% CI 0.58-1.02). No difference was observed in all-cause deaths in the GCS group compared with the control group (RR 0.77; 95% CI 0.56-1.06).
  
  
  CONCLUSIONS
  When analyzing lower-quality studies or only clean procedures, GCS significantly reduced the risk of SSI. Further high-quality randomized studies are needed to confirm the benefit of GCS for lowering mortality rates.
authors.affiliation: 1 Alfa Institute of Biomedical Sciences (AIBS) , Athens, Greece .|2 Department of Neurosurgery, Agios Savvas Regional Cancer Hospital , Athens, Greece .
authors.forename: Athanasios A
authors.initials: AA
authors.lastname: Konstantelias
authors.affiliation: 1 Alfa Institute of Biomedical Sciences (AIBS) , Athens, Greece .|3 Department of Medicine, Karolinska Institutet and University Hospital , Stockholm, Sweden .
authors.forename: Konstantinos A
authors.initials: KA
authors.lastname: Polyzos
authors.affiliation: 1 Alfa Institute of Biomedical Sciences (AIBS) , Athens, Greece .|4 Department of Medicine-Infectious Diseases, Iaso General Hospital , Athens, Greece .|5 Department of Medicine, Tufts University School of Medicine , Boston, Massachusetts.
authors.forename: Matthew E
authors.initials: ME
authors.lastname: Falagas
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003094:Collagen / Q000627:therapeutic use*; D005839:Gentamicins / Q000008:administration & dosage / Q000627:therapeutic use*; D006801:Humans; D008875:Middle Aged; D016032:Randomized Controlled Trials as Topic; D015503:Surgical Sponges / Q000706:statistics & numerical data*; D013530:Surgical Wound Infection / Q000453:epidemiology* / Q000517:prevention & control*; D055815:Young Adult
chemical_list: D005839:Gentamicins; D003094:Collagen