Gentamicin-collagen implants to reduce surgical site infection: systematic review and meta-analysis of randomized trials

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#anti-bacterial-agents #antibiotic-prophylaxis #collagen #drug-implants #gentamicins

Gentamicin-collagen implants to reduce surgical site infection: systematic review and meta-analysis of randomized trials

Chang et al., 2013 | Ann Surg | Meta Analysis

Citation

Chang Wai Keat, Srinivasa Sanket, ... Hill Andrew G. Gentamicin-collagen implants to reduce surgical site infection: systematic review and meta-analysis of randomized trials. Ann Surg. 2013-Jul;258(1):59-65. doi:10.1097/SLA.0b013e3182895b8c

Abstract

OBJECTIVE: To determine whether gentamicin-impregnated collagen sponges (gentamicin-collagen implants) decrease the incidence of surgical site infection (SSI). BACKGROUND: SSIs cause substantial morbidity and increase the costs of healthcare. Antibiotic prophylaxis is a cornerstone of SSI reduction. Prophylactic local delivery of antibiotics with novel biodegradable drug carrier systems, such as the gentamicin-collagen implant, is a potential avenue for SSI reduction. Gentamicin-collagen implants have been previously assessed in multiple randomized controlled trials (RCTs) with conflicting results. Therefore, a systematic review and meta-analysis of all relevant RCTs was conducted to determine whether gentamicin-collagen implants reduce SSI. METHODS: Major medical databases and trial registers were searched for published and unpublished RCTs. The endpoint of interest was the incidence of SSI. A random effects model was used and pooled estimates were reported as odds ratios (ORs), with the corresponding 95% confidence interval (CI). A subset analysis by incision type was planned a priori. RESULTS: Fifteen RCTs encompassing a total of 6979 patients were included in the final analysis. The included studies were of moderate to high quality. Gentamicin-collagen implants significantly reduced SSI [OR = 0.51; 95% CI: 0.33-0.77; P = 0.001; number needed to treat (NNT) = 21; I = 75%]. These results were seen in subset analysis of clean (OR = 0.53; 95% CI: 0.33-0.87; P = 0.01; NNT = 30) and clean-contaminated surgery (OR = 0.43; 95% CI: 0.20-0.93; P = 0.03; NNT = 9) specifically. CONCLUSIONS: Gentamicin-collagen implants decrease the rate of SSI.

Key Findings

Fifteen RCTs encompassing a total of 6979 patients were included in the final analysis. The included studies were of moderate to high quality. Gentamicin-collagen implants significantly reduced SSI [OR = 0.51; 95% CI: 0.33-0.77; P = 0.001; number needed to treat (NNT) = 21; I = 75%]. These results were seen in subset analysis of clean (OR = 0.53; 95% CI: 0.33-0.87; P = 0.01; NNT = 30) and clean-contaminated surgery (OR = 0.43; 95% CI: 0.20-0.93; P = 0.03; NNT = 9) specifically.

Outcomes Measured

  • Requires manual extraction

Population

Field Value
Population See abstract
Sample Size 6979
Age Range See abstract
Condition See abstract

MeSH Terms

  • Anti-Bacterial Agents
  • Antibiotic Prophylaxis
  • Collagen
  • Drug Implants
  • Gentamicins
  • Humans
  • Randomized Controlled Trials as Topic
  • Surgical Wound Infection

Evidence Classification

  • Level: Meta Analysis
  • Publication Types: Journal Article, Meta-Analysis, Systematic Review
  • Vertical: collagen

Provenance

Source extracted via PubMed E-utilities API on 2026-04-09