Gentamicin-Collagen Sponges Reduce Risk of SSIs in Cardiac Procedures
SAN DIEGO, CA—Use of gentamicin-collagen sponges reduced risk of surgical site infections (SSIs) following cardiac—but not colorectal—procedures, according to the first meta-analysis to assess the effectiveness of such sponge use for preventing SSIs in different types of operations reported during IDWeek 2012.
“Despite routine use of prophylactic antimicrobial agents, SSIs continue to cause significant morbidity,” Michelle Formanek, BS, from the University of Iowa College of Public Health, Iowa City, and colleagues noted in explaining the study's rationale.
After searching PUBMED and CINAHL databases from January 1990–January 31, 2012, and extracting data, the investigators pooled odds ratios from 13 independent study populations, including four in cardiac, five in colorectal, two in gastrointestinal and two in hernia patients.
“When results of all studies were pooled in a random effects model, a significant protective effect was observed between prophylactic use of gentamicin-collagen sponges and SSI (pooled OR: 0.66; 95% CI 0.45–0.97),” the team reported.
After stratifying the data by sponge type (eg, bundled intervention vs. sponge only) and study quality, the results did not change; however, when stratified by operation, a significant protective effect was observed for cardiac (pooled OR 0.59, 95% CI, 0.37–0.96) but not colorectal procedures (pooled OR 1.07; 95% CI, 0.80–1.44). Two studies performed in the United States did not show reduced risk of SSI – one that caused statistically significant harm (colorectal), and one did that was not statistically significant (cardiac).
“Upon analyses of various types of surgeries and various types of sponges utilized, it can be concluded that the gentamicin-collagen sponge showed statistically significant protection in cardiac surgeries, but not in colorectal surgeries,” concluded Formanek. Study investigators added that further stratifications are needed in examining different pathogens involved in the cardiac setting vs. the colorectal settings.