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. 2019 Aug 2:4:100090.
doi: 10.1016/j.eurox.2019.100090. eCollection 2019 Oct.

Adhesive incisional drapes during cesarean delivery for preventing wound infection: A systematic review and meta-analysis of randomized controlled trials

Rebecca Eckler  1 , Johanna Quist-Nelson  2 , Gabriele Saccone  3 , Harvey Ward  4 , Vincenzo Berghella  2
Affiliations

Adhesive incisional drapes during cesarean delivery for preventing wound infection: A systematic review and meta-analysis of randomized controlled trials

Rebecca Eckler et al. Eur J Obstet Gynecol Reprod Biol X. .

Abstract

Objective: To compare the incidence of wound infection after cesarean delivery in procedures conducted using adhesive incisional drapes verses no adhesive incisional drapes.

Study design: Searches were performed in electronic databases (MEDLINE, ClinicalTrials.gov, the Cochrane Central Register of Controlled Trials, Scopus, OVID, EMBASE, and the PROSPERO International Prospective Register of Systematic Reviews). We included randomized controlled trials comparing adhesive incisional drapes to no adhesive incisional drapes during cesarean delivery. The primary outcome of this meta-analysis was wound infection. Meta-analysis was performed using the random effects model of DerSimonian and Laird, to produce relative risk (RR) with 95% confidence interval (CI).

Results: 52 publications were identified through initial search of databases and two randomized controlled trials were eligible and included in the meta-analysis. Our meta-analysis examined a total of 1943 subjects and showed a statistically significant increase in wound infections in patients in the adhesive incisional drape group when compared to the control group (RR: 1.29, 95% CI: 1.02-1.65).

Conclusion: Adhesive incisional drapes may increase the incidence of wound infections after cesarean delivery. Further studies are necessary to explore this relationship in the setting of current postoperative infection prophylaxis, including broad-spectrum antibiotic coverage, skin preparation and vaginal cleansing.

Keywords: Adhesive drapes; Cesarean delivery; Plastic drapes; Postoperative infection; Surgical site infection.

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Conflict of interest statement

All authors declare no conflicts of interest. The authors alone are responsible for the content and writing of this article.

Figures

Fig. 1
Fig. 1
Examples of drapes similar to those studied in this meta-analysis (A) adhesive incisional drapes (B) no adhesive incisional drapes.
Fig. 2
Fig. 2
PRISMA flowchart for study selection.
Fig. 3
Fig. 3
Assessment of risk of bias. (A) Summary of risk bias for each trial; plus sign, low risk of bias; minus sign, high risk of bias; question mark; unclear risk of bias. (B) Risk of bias as a graph about each risk of bias item presented as percentages across all included studies.
Fig. 4
Fig. 4
Forest plot for the meta-analysis of the incidence of wound infection in patients using adhesive incisional drapes during cesarean delivery.
See this image and copyright information in PMC

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