Use of iodine-impregnated surgical drapes for prevention of surgical site infection: A systematic review and meta-analysis

Abstract

Background Iodine-impregnated surgical drapes aim to protect the wound from bacterial re-colonisation and therefore prevent surgical site infection (SSI). Studies have produced conflicting results regarding the efficacy of this intervention. Methods Ovid EMBASE, Ovid MEDLINE, Scopus and PubMed were searched for randomised control trials (RCTs) and cohort studies in which iodine-impregnated drapes were used to reduce SSI. The risk of bias was evaluated using the Cochrane Risk of Bias 2.0 tool for RCTs and the ROBINS-I tool for cohort studies. RevMan was used for meta-analysis. Additional sub-group analysis was performed for incision type. Results Two RCTs and seven cohort studies inclusive of 4119 patients were included. The RCTs demonstrate a risk ratio (RR) for SSI in the intervention group of 0.92 (p=0.70), whereas the RR in the cohort studies is 0.45 (p=0.01). The number needed to prevent SSI in the cohort studies is 19.5. There is also a statistically significant reduction in SSI in the intervention group for clean-contaminated incisions, with SSI occurring in 3.8% of surgeries with an iodophor drape and 9.2% of surgeries without (RR 0.45, p=0.02). Conclusion Our review suggests that iodine-impregnated drapes are beneficial in reducing postoperative SSI, particularly in clean-contaminated surgeries; however, the grade of evidence is poor.