Summary of findings 3. Silver dressing compared with exposed wound.
| Silver dressing compared with exposed wound | ||||||
|
Patient or population: surgical wounds resulting from surgery at risk of contamination and healing by primary intention
Setting: postsurgical
Intervention: exposed wounds Comparison: silver dressing | ||||||
| Outcomes | Anticipated absolute effects* (95% CI) | Relative effect (95% CI) | № of participants (studies) | Quality of the evidence (GRADE) | Comments | |
| Risk with silver dressing | Risk with exposed wound | |||||
| SSI
Assessment method: CDC definition of SSI Follow‐up: mean 30 days |
96 per 1000 | 771 per 1000 (98 to 1000) |
RR 8.00 (1.02 to 62.55) | 166 (1 RCT) |
⊕⊝⊝⊝ VERY LOW 1 2 | It is uncertain whether leaving wounds exposed following surgery at risk of contamination leads to an increase or decrease in risk of SSI compared with use of a silver dressing, as the certainty of the evidence has been assessed as very low. |
| Risk difference: 675 more SSIs per 1000 with exposed wounds (2 more to 1000 more) | ||||||
| Scarring | Not estimable | Not estimable | Not estimable | n/a | n/a | Outcome not measured or reported for this comparison. |
| Acceptability | Not estimable | Not estimable | Not estimable | n/a | n/a | Outcome not measured or reported for this comparison. |
| Ease of dressing removal | Not estimable | Not estimable | Not estimable | n/a | n/a | Outcome not measured or reported for this comparison. |
| *The risk in the intervention group (and its 95% confidence interval) is based on the assumed risk in the comparison group (exposed wounds) and the relative effect of the intervention (and its 95% CI). CDC: Centers for Disease Control and Prevention; CI: confidence interval; n/a: not applicable; OIS: optimal information size; RCT: randomised controlled trial; RR: risk ratio SSI: surgical site infection; | ||||||
| GRADE Working Group grades of evidence High certainty: we are very confident that the true effect lies close to that of the estimate of the effect Moderate certainty: we are moderately confident in the effect estimate: The true effect is likely to be close to the estimate of the effect, but there is a possibility that it is substantially different Low certainty: our confidence in the effect estimate is limited: The true effect may be substantially different from the estimate of the effect Very low certainty: we have very little confidence in the effect estimate: The true effect is likely to be substantially different from the estimate of effect | ||||||
1 The study in this comparison was underpowered with a small sample size and a low number of events: the OIS was not met. 95% CIs were very wide ranging from a 2% increase in SSI risk to a 525% increased risk for exposed wounds. Downgraded twice for imprecision.
2 Risk of bias as unclear for sequence generation and allocation concealment. Downgraded once for study limitations.