The efficacy of wound edge protectors in reducing the post-operative surgical site infections after abdominal surgery: a meta-analysis of randomized clinical studies

Introduction
Following abdominal surgery, surgical site infections (SSIs) are a common complication. The effectiveness of wound edge protectors in preventing SSI remains uncertain.

Aim
To determine the clinical effectiveness of a wound edge protector (WEP) in preventing surgical site infections (SSIs) after abdominal surgery.

Material and methods
A systematic search of the Cochrane Library, PubMed, Embase, and Web of Science yielded all relevant articles published through October 2022. The major evidence regarding the efficacy of WEPs in minimizing SSIs in abdominal surgery patients relative to the standard of care was determined by searching the literature. The primary outcome was SSI as clinically defined by CDC. To combine qualitative factors, risk ratios (RRs) were used.

Results
WEPs were related to a decreased incidence of SSI overall (RR = 0.75; 95% CI: 0.61–0.91; p = 0.004). WEPs are efficient in lowering the incidence of SSI at various abdominal surgical sites, with RR = 0.67; 95% CI: 0.47–0.96; p = 0.03 for pancreatoduodenectomy, RR = 0.52; 95% CI: 0.31–0.86; p = 0.01 for colorectal surgery, and RR = 0.39; 95% CI: 0.21–0.73; p = 0.003 for abdominal surgery. Moreover, both kinds of WEPs (single-ring and double-ring devices) were successful in lowering the risk of SSIs, with RR = 0.66; 95% CI: 0.47–0.93; p = 0.02 for double-ring devices and RR = 0.76; 95% CI: 0.58–0.98; p = 0.04 for single-ring devices.

Conclusions
These findings demonstrate that double- and single-ring wound edge protection devices are effective in preventing surgical site infections following pancreatoduodenectomy, colorectal, and abdominal procedures.