Wound edge protector for prevention of surgical site infection in laparotomy: An updated systematic review and meta-analysis

Zhang MX, Sun YH, Xu Z, Zhou P, Wang HX, Wu YY

"Our exploratory meta-analysis suggests that [Wound Edge Protector] reduces the incidence of SSI in patients receiving laparotomies, especially in the circumstance of dual-ring WEP and in contaminated incisions. In order to fully assess the effectiveness of WEP, large-scale and well-designed RCTs are still needed in the future."

Multicenter double-blinded randomized controlled trial of standard abdominal wound edge protection with surgical dressings versus coverage with a sterile circular polyethylene drape for prevention of surgical site infections: A CHIR-Net trial

Mihaljevic AL, Schirren R, Özer M, Ottl S, Grün S, Michalski CW, Erkan M, Jäger C, Reiser-Erkan C, Kehl V, Schuster T, Roder J, Clauer U, Orlitsch C, Hoffmann TF, Lange R, Harzenetter T, Steiner P, Michalski M, Henkel K, Stadler J, Pistorius GA, Jahn A, Obermaier R, Unger R, Strunk R, Willeke F, Vogelsang H, Halve B, Dietl KH, Hilgenstock H, Meyer A, Krämling HJ, Wagner M, Schoenberg MH, Zeller F, Schmidt J, Friess H, Kleeff J

"Our trial shows that [circular plastic wound edge protectors] are effective at reducing the incidence of SSIs in elective and clean or clean-contaminated open abdominal surgery."

The cost-effectiveness of wound-edge protection devices compared to standard care in reducing surgical site infection after laparotomy: An economic evaluation alongside the ROSSINI trial

Gheorghe A, Roberts TE, Pinkney TD, Bartlett DC, Morton D, Calvert M; West Midlands Research Collaborative; ROSSINI Trial Investigators

"There is no evidence to suggest that [wound-edge protection devices] can be considered a cost effective device to reduce SSI. Their continued use is a waste of limited health care resources."

Impact of wound edge protection devices on surgical site infection after laparotomy: multicentre randomised controlled trial (ROSSINI Trial)

Pinkney TD, Calvert M, Bartlett DC, Gheorghe A, Redman V, Dowswell G, Hawkins W, Mak T, Youssef H, Richardson C, Hornby S, Magill L, Haslop R, Wilson S, Morton D; West Midlands Research Collaborative and the ROSSINI Trial Investigators

A prospective, multicenter, observer blinded, randomised controlled trial including 735 patients undergoing laparotomy evaluated the clinical effectiveness of wound edge protection devices in reducing surgical site infection. Ninety one of 369 (24.7%) patients in the device group experienced a surgical site infection and 93 of 366 (25.4%) patients in the control group experienced a surgical site infection. The study concluded that wound edge protection devices do not reduce the rate of surgical site infection in patients undergoing laparotomy.

Reduction of wound infections in laparoscopic-assisted colorectal resections by plastic wound ring drapes (REDWIL)?—a randomized controlled trial

Lauscher JC, Grittner F, Stroux A, Zimmermann M, le Claire M, Buhr HJ, Ritz JP

A randomized controlled monocenter trial including 109 patients (46 with ring drapes and 47 without ring drapes) undergoing elective laparoscopic colorectal resections evaluated the rate of SSI and inpatient cost of surgeries. Results showed that plastic wound ring drapes do not reduce the rate of SSIs and that the inpatient costs were similar in both groups.

Ring drape do not protect against surgical site infections in colorectal surgery: a randomised controlled study

Baier P, Kiesel M, Kayser C, Fischer A, Hopt UT, Utzolino S

A prospective, randomised, controlled study including 199 patients undergoing colorectal surgery compared two kinds of wound protection and their effect on the rate of SSI. Ninety-eight out of 199 patients were randomised to the "plastic ring drapes" group and the remaining 101 patients were randomised to the "standard cloth towels" group. Study results indicated that the use of ring drape in colorectal surgery do not reduce incidence of SSI.

Systematic Review of the Clinical Effectiveness of Wound-edge Protection Devices in Reducing Surgical Site Infection in Patients Undergoing Open Abdominal Surgery

Gheorghe A, Calvert M, Pinkney TD, Fletcher BR, Bartlett DC, Hawkins WJ, Mak T, Youssef H, Wilson S

A systematic review including 12 studies evaluating surgical site infection rate concluded that wound-edge protection devices may be efficient in reducing SSI rates in patients undergoing open abdominal surgery.

Effectiveness of using Wound Retractor for preventing post-operative SSI in colorectal surgeries (in Japanese)

Hirohashi Y, Kitagawa H, Okuyama K, Urata M, Hashiguchi K, Tanaka M, Tanaka T, Sato K

An analysis of methods of wound margin protection for 375 colorectal cases found that using no drape resulted in a 27.6% SSI rate (52 out of 190), using a ring drape resulted in a 24.3% SSI rate (18 out of 74), and using a wound retractor resulted in a 3.4% SSI rate (4 out of 118) – one-seventh of the ring drape SSI rate. Investigators consider that using the wound retractor is cost effective, especially for contaminated procedures such as colorectal surgery.

The use of ring drapes in abdominal surgery (in French)

Brunet P, Bounoua F, Bugnon PY, Gautier-Benoit C

A study including 149 cases of persons undergoing abdominal surgery concluded that the protective effect from surgical wound infection by ring drapes was statistically significant; thus, they have a role to play in the fight against post-operative wound infections.