Gentamicin/CollagenSpongeUseMayReducetheRiskofSurgicalSiteInfectionsforPatientsUndergoingCardiacOperations:AMeta-AnalysisMichelleB.Formanek,1,2LoreenA.Herwaldt,1,3EliN.Perencevich,2,3andMarinL.Schweizer1–3AbstractObjective:Ameta-analysisofallpublishedrandomizedcontrolledtrialsoftheeffectivenessofgentamicin/collagenspongesforpreventingsurgicalsiteinfections(SSIs).Background:Despiteroutineuseofsystemicprophylacticantimicrobialagents,SSIscontinuetobeassociatedwithsubstantialmorbidity.Resultsconflictofstudiesoftheefficacyofgentamicin/collagenspongesforpre-ventingSSIs.However,manyofthesestudieshaveassessedspongeuseinonlyasinglespecifictypeofoperation.Thegeneraleffectofspongeuseamongdifferenttypesofoperationshasnotbeenpreviouslyas-sessed.Methods:ThePubMedandCumulativeIndextoNursingandAlliedHealthLiterature(CINAHL)databasesweresearchedforarticlesappearingfrom1990throughJanuary2012thatwererelatedtogentamicin/collagenspongeuseandSSIs.Summaryestimateswereobtainedthrougharandomeffectsmodel.Afterreviewing714articleabstractsandreviewing22articlesindetail,wepooledtheoddsratios(OR)for13independentstudypopulations(cardiac,n=4;colorectal,n=4;pilonidalsinus,n=2;hernia,n=2;gastrointestinal,n=1)inwhichtheassociationbetweenprophylacticuseofgentamicin/collagenspongesandSSIswasassessed.Results:Poolingoftheresultsofallstudiesincludedinthereviewinarandomeffectsmodelshowedasignificantprotectiveeffectofprophylacticuseofgentamicin/collagenspongesagainstSSI(pooledOR:0.66;95%confidenceinterval[CI]:0.45,0.97;n=13).However,whenthedatawerestratifiedbytypeofoperation,asignificantprotectiveeffectwasobservedincardiacprocedures(pooledOR:0.59;95%CI:0.37,0.96;n=4)butnotincolorectalprocedures(pooledOR:0.74;95%CI:0.29–1.92;n=4).Conclusion:Useofgentamicin/collagenspongeswasassociatedwithareducedriskofSSIfollowingcardiacoperationsbutnotfollowingcolorectalprocedures.Surgicalsiteinfections(SSIs)areamongthemostcommontypesofhealthcare-associatedinfections[1].Despitetheroutineuseofsystemicprophylacticantimic...
