Silver-based dressings for the prevention of surgical site infections: evidence from randomized trials

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Background Surgical site infections (SSIs) are a major cause of postoperative complications, increasing morbidity and healthcare costs. Silver-based dressings are commonly used due to their antimicrobial properties, but their effectiveness in reducing SSIs remains unclear. Aim This systematic review and meta-analysis aim to evaluate the efficacy of silver-based dressings compared to non-silver dressings in preventing SSIs in randomized controlled trials (RCTs) Methods A systematic search was conducted in PubMed, Cochrane Library, and Embase to identify RCTs comparing silver-based to non-silver dressings for SSI prevention. The study protocol was registered in PROSPERO (CRD42024592966). Meta-analysis using random-effects models calculated pooled risk ratios (RR) with 95% confidence intervals (CI). Heterogeneity was assessed with the I 2 statistic, and publication bias evaluated through funnel plots and Egger's test. Results : 12 RCTs with 2,928 participants were included in the meta-analysis. Silver-based dressings significantly reduced SSI risk by 40% compared to non-silver dressings (RR: 0.60, 95% CI: 0.41-0.89, p<0.05), with moderate heterogeneity (I 2 = 53%) Conclusions : Silver-based dressings significantly reduce the risk of SSIs; however, further high-quality RCTs are needed to confirm their benefits across different surgical contexts and patient populations.