TTP2.07 Evaluating the Effectiveness of Gentamicin-Impregnated Collagen Sponge in Preventing Surgical Site Infections in Colorectal Surgery: A Systematic Literature Review and Meta-Analysis

Aim Despite numerous randomised controlled trials evaluating the effectiveness of Gentamicin - Collagen Implant (GCI) in preventing Surgical Site Infections (SSI) in colorectal surgery, the results have been conflicting. This meta-analysis aims to determine the true efficacy of GCI in reducing SSI incidence in colorectal surgery. Method A systematic literature search of medical databases was conducted using the PRISMA framework. Relevant data were extracted and analysed using the Review Manager software. The primary end point was SSI, while the secondary outcomes were primary wound healing, pilonidal disease recurrence and distant metastasis in rectal cancer. Result Seventeen articles comprising 3,041 patients were analysed. GCI significantly reduced the overall incidence of SSI (p = 0.0001; OR = 0.68; 95% CI = 0.56 – 0.82) and, particularly, in rectal surgeries (p = 0.0003; OR = 0.43, 95% CI 0.27 – 0.68). GCI had no effect on pilonidal disease (p = 0.09; OR = 0.25; 95% CI = 0.05 – 1.22) or its recurrence (p = 0.63; OR = 0.59; 95% CI = 0.07 – 4.88). Notably, GCI significantly reduced distant metastatic recurrence when placed in the pelvic cavity during total mesorectal excision for rectal cancer (p = 0.0001; OR = 0.39; 95% CI = 0.24 – 0.63). Conclusion GCI significantly reduces SSI incidence in colorectal surgeries, especially in rectal surgeries, but does not show efficacy for pilonidal disease. Routine use of GCI in rectal surgeries is recommended. Further studies are needed to elucidate its impact on distant metastatic recurrence of rectal cancers.