Cosker 2005.
| Methods | 3‐arm RCT, undertaken in the UK | |
| Participants | People undergoing hip or knee surgery (trauma and elective cases). Those who failed to give consent, or who had dressing allergies were excluded. 100 participants were randomised to each dressing group (total n = 300). | |
| Interventions | Group A (n = 100): standard absorbent dressing (Primapore, Smith & Nephew)
Group B (n = 100): transparent film dressing and pad (Tegaderm and pad, 3M Healthcare)
Group C (n = 100): film dressing (Opsite Post‐Op, Smith & Nephew) Stated that all dressings were used according to manufacturers' instructions, but no further details provided. We merged Groups B and C and treated this as a 2‐arm trial in this review. |
|
| Outcomes | Primary review outcome: SSI (not defined); trial reported "numbers of patients in each group who progressed to overt infection" and required antimicrobial therapy. Secondary review outcomes: not reported | |
| Notes | Trial outcome data: see Table 12 Included some implants (i.e. screws) Follow‐up not reported |
|
| Risk of bias | ||
| Bias | Authors' judgement | Support for judgement |
| Random sequence generation (selection bias) | Unclear risk | Quote: "Randomisation was effected by indicating the dressing in an envelope, which was opened by the theatre sister at the end of the operation." Comment: unclear how sequence was generated. |
| Allocation concealment (selection bias) | Unclear risk | See above. The paper notes that participants in the film dressing (Opsite) group were "significantly older" than in the other groups. No data presented. |
| Blinding (performance bias and detection bias) All outcomes | Unclear risk | No mention of blinding in the trial report. |
| Incomplete outcome data (attrition bias) All outcomes | Unclear risk | There were 14 exclusions and it was unclear whether these were pre‐ or post‐randomisation. |
| Selective reporting (reporting bias) | Low risk | Given the information presented in the paper, all prespecified outcomes were reported. |
| Other bias | High risk | It seems that there was baseline imbalance in age, but no data were reported beyond the details in the text. |