Evidence map›Paper›PMID 25681239›Full record

SynthesisLangenbeck's archives of surgery2015

Intra-operative wound irrigation to reduce surgical site infections after abdominal surgery: a systematic review and meta-analysis.

Tara C Mueller, Martin Loos, Bernhard Haller, André L Mihaljevic, Ulrich Nitsche, Dirk Wilhelm, Helmut Friess, Jörg Kleeff, Franz G Bader

2 registry-linked trialsAbstract readMeta-AnalysisSystematic Review
PubMed Publisher
In one paragraph

Synthesis in Langenbeck's archives of surgery, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 57 papers, 9 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
57citing papers in PubMed, 9 pooled it
13.3field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT03816995 nacompletednot on this mapstarted 2019, after this paper: background citation

A Novel Wound Retractor Combining Continuous Irrigation and Barrier Protection Reduces Incisional Contamination and Surgical Site Infection in Colorectal Surgery

TypeinterventionalSponsorScott SteeleRan2019 to 2023Enrolled702ConditionsColorectal SurgeryArmsCleanCision Wound Retraction and Protection System, Alexis O Wound Protector
NCT06338163 phase4unknown statusnot on this mapstarted 2024, after this paper: background citation

Polihexanide SSIs Measures Bundle (PSMB) During Enhanced Recovery After Major Digestive Surgery

TypeinterventionalSponsorMarco CatarciRan2024 to 2025Enrolled2,000ConditionsSurgical Site Infection, Surgical Procedures, OperativeArmsPolihexanide-based bundle, Standard bundle
3 · Its place in the literature

Who cites it

57 citing papers in PubMed, 9 syntheses or guidelines pooled it, 155 citations in OpenAlex.

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  17. Saline solution vs. stabilized isotonic sodium hypochlorite lavage in complicated appendicitis: a comparative study.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2026
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 1 institution in 1 country.

Tara C MuellerDepartment of Surgery, Klinikum rechts der Isar, Technische Universität München, Ismaninger Str. 22, 81675, Munich, Germany, tara.mueller@tum.de.
Martin Loos
Bernhard Haller
André L Mihaljevic
Ulrich Nitsche
Dirk Wilhelm
Helmut Friess
Jörg Kleeff
Franz G Bader
Technical University of Munich · DE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeSurgical site infection (SSI) remains to be one of the most frequent infectious complications following abdominal surgery. Prophylactic intra-operative wound irrigation (IOWI) before skin closure has been proposed to reduce bacterial wound contamination and the risk of SSI. However, current recommendations on its use are conflicting especially concerning antibiotic and antiseptic solutions because of their potential tissue toxicity and enhancement of bacterial drug resistances.

methodsTo analyze the existing evidence for the effect of IOWI with topical antibiotics, povidone-iodine (PVP-I) solutions or saline on the incidence of SSI following open abdominal surgery, a systematic review and meta-analysis of randomized controlled trials (RCTs) was carried out according to the recommendations of the Cochrane Collaboration.

resultsForty-one RCTs reporting primary data of over 9000 patients were analyzed. Meta-analysis on the effect of IOWI with any solution compared to no irrigation revealed a significant benefit in the reduction of SSI rates (OR = 0.54, 95 % confidence Interval (CI) [0.42; 0.69], p < 0.0001). Subgroup analyses showed that this effect was strongest in colorectal surgery and that IOWI with antibiotic solutions had a stronger effect than irrigation with PVP-I or saline. However, all of the included trials were at considerable risk of bias according to the quality assessment.

conclusionThese results suggest that IOWI before skin closure represents a pragmatic and economical approach to reduce postoperative SSI after abdominal surgery and that antibiotic solutions seem to be more effective than PVP-I solutions or simple saline, and it might be worth to re-evaluate their use for specific indications.

Indexed as

Abdominal CavityFemaleFollow-Up StudiesHumansIncidenceIntraoperative CareLaparotomyMaleRandomized Controlled Trials as TopicRisk AssessmentSurgical Wound InfectionTherapeutic IrrigationTreatment OutcomeWound Healing

Identifiers

PMID25681239
OpenAlexW1980111928

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.