Do Adhesive Surgical Drapes Decrease the Risk for Postoperative Wound Contamination?

Results of a systematic review and meta-analysis found that adhesive drapes, with or without antimicrobial properties, were associated with a decreased risk for postoperative wound contamination. These findings were published in Clinical Orthopedics and Related Research.

Researchers from the University of Toronto in Canada searched publication databases for studies on the relationship between adhesive drapes and wound contaminations following orthopedic procedures. A total of 5 studies were included in the qualitative synthesis and 4 were in the quantitative synthesis.

The studies included in the meta-analysis were randomized (n=4) or quasi-randomized clinical trials (n=1) published between 2018 and 2020. In addition, the 5 studies were conducted in Iran (n=2), Denmark (n=1), Japan (n=1), and the United States (n=1).

Of the included studies, the population of each study ranged between 88 and 1187 patients, the mean age ranged between 37 and 67 years, and 40% to 70% of those included were men.

The types of drapes assessed included iodine-impregnated drapes for total knee replacements, femoroacetabular osteoplasty, or periacetabular osteotomy; adhesive drapes for total hip replacements; sterile adhesive drapes for rotator cuff repair; and nonimpregnated drapes for lumbar spine procedures.

Compared with no adhesive drape use, the use of adhesive drapes was associated with a decreased risk for postoperative wound contamination (odds ratio [OR], 0.49; 95% CI, 0.34-0.72; P <.001). Of note, a similar pattern was found for the 2 trials which used antiseptic-infused drapes (OR, 0.58; 95% CI, 0.41-0.80; P =.001).

The 2 trials which assessed the use of antiseptic-infused drapes also assessed the effect of adhesive failure on the risk for postoperative wound contamination. For drapes that peeled back no more than 1 cm from the wound edge, the researchers noted an associated decreased risk for postoperative wound contamination (OR, 0.6; 95% CI, 0.43-0.86; P =.005).

The study limitations included the potential risk of bias and the paucity of available data.

These data indicated that adhesive drapes, with or without antimicrobial properties, were effective at protecting against postoperative wound contamination. "If feasible, large clinical trials that evaluate the efficacy of adhesive drapes [in decreasing the risk for] surgical site infections would be warranted to understand the true value or harm associated with [the use of adhesive] drapes," the researchers concluded.

Mundi R, Nucci N, Ekhtiari S, Wolfstadt J, Ravi B Chaudhry H. Do adhesive drapes have an effect on infection rates in orthopaedic surgery? A systematic review and meta-analysis. Clin Orthop Relat Res. Published online September 7, 2021. doi:10.1097/CORR.0000000000001958