Objective: This meta-analysis aimed to explore the impact of prophylactic negative pressure wound therapy (NPWT) on the occurrence of deep surgical site infections (SSIs) following orthopedic surgery.

Methods: A systematic search was conducted across Medline, Embase, Cochrane Library, and Web of Science databases for articles concerning NPWT in patients who underwent orthopedic surgery up to May 20, 2024. Using Stata 15.0, the combined odds ratios (ORs) were calculated with either a random-effects model or a fixed-effects model, depending on the heterogeneity values.

Results: From a total of 440 publications, studies that utilized NPWT as the experimental group and conventional dressings as the control group were selected to analyze their impact on SSIs. Ultimately, 32 studies met the inclusion criteria. These included 12 randomized controlled trials and 20 cohort studies, involving 7454 patients, with 3533 of whom received NPWT and 3921 of whom were treated with conventional dressings. The results of the meta-analysis demonstrated that the NPWT group had a lower incidence of deep SSIs in orthopedic surgeries than did the control group [OR 0.64, 95% CI (0.52, 0.80), P = 0.0001]. Subgroup analysis indicated a notable difference for trauma surgeries [OR 0.65, 95% CI (0.50, 0.83), P = 0.001], whereas joint surgeries [OR 0.65, 95% CI (0.38, 1.12), P = 0.122] and spine surgeries [OR 0.61, 95% CI (0.27, 1.35), P = 0.221] did not show significant differences. Additionally, when examined separately according to heterogeneity, trauma surgeries exhibited a significant difference [OR 0.50, 95% CI (0.31, 0.80), P = 0.004].

Conclusion: The results of our study indicate that the prophylactic use of NPWT reduces the incidence of deep SSIs following orthopedic trauma surgery when compared to the use of conventional dressings. We postulate that the prophylactic application of NPWT in patients at high risk of developing complications from bone trauma may result in improved clinical outcomes and an enhanced patient prognosis.

Objective: The ulcers of lower extremities, both venous and diabetic, impose a massive burden on sufferers globally. This meta-analysis evaluates the efficacy of silver dressings in improving healing rate of these ulcers.

Methods: We carried out comprehensive searches in PubMed, Embase, Web of Science, the Cochrane Library, and China National Knowledge Internet (CNKI) up to March 2024. Two reviewers independently screened the study and extracted data. While the primary outcome was wound healing rate, secondary outcomes included wound healing area and recurrence rate. Data were analyzed using Stata 16.0. software.

Results: A total of 18 studies involving 1825 participants were included. Silver dressings demonstrated statistically significant effects in improving healing rates for diabetic foot ulcers (DFU) (OR 2.14, 95% CI: 1.52, 3.00, p = 0.00), whereas the effects were not statistically significant for venous leg ulcers (VLU) (OR 1.32, 95% CI: 0.97, 1.78, p = 0.07). Silver dressings also reduced ulcer area by 27.44 cm2 (95% CI 6.96 to 47.92) and recurrence rate of 45% (95% CI 0.11 to 1.79). Subgroup analysis revealed that the Asia-Pacific region and treatments of six weeks or less exhibited higher healing rates than their respective counterparts, although there was no statistical significance.

Conclusions: This study indicated a statistically significant benefit of the treatment for DFU. However, the effect on VLU, though positive, did not reach statistical significance. This distinction should be considered in clinical application and further research.

Background: Third molar surgery often results in postoperative complications such as pain, trismus, and facial swelling due to surgical trauma. Concentrated Growth Factor (CGF), a third-generation platelet concentrate, is believed to enhance wound healing due to its rich content of growth factors and fibrin.

Methods: This systematic review followed PRISMA guidelines and included a search of PubMed, Embase, and Cochrane Library up to April 18, 2024. Randomized controlled trials involving CGF-treated versus non-CGF-treated patients undergoing third molar surgery were included. Risk of bias was assessed using the Cochrane Collaboration RoB 2.0.

Results: Ten studies were included. CGF significantly improved wound healing, with enhanced soft and hard tissue recovery. Pain relief was notable on postoperative days 3 and 7, although results varied. CGF reduced facial swelling significantly on days 3 and 7 post-surgery. Trismus outcomes were mixed, with some studies reporting significant alleviation and others showing no advantage. CGF showed potential in reducing dry socket incidence, though evidence was not robust.

Conclusions: CGF appears to promote wound healing and reduce postoperative complications such as pain and swelling after third molar surgery. However, its effects on trismus and dry socket incidence remain controversial. Further research with standardized measures is needed to confirm these findings.

Background: Surgical site infections continue to be a significant challenge following colorectal surgery. These can result in extended hospital stays, hospital readmissions, increased treatment costs, and negative effects on patients' quality of life. Antibiotic prophylaxis plays a crucial role in preventing infection during surgery, specifically in preventing surgical site infections after colorectal surgery in adult patients. However, the optimal antibiotic regimen is still unclear based on current evidence. Considering the limitations of existing reviews, our goal is to conduct a comprehensive systematic review and network meta-analysis of randomized controlled trials to evaluate the comparative benefits and harms of available antibiotic prophylaxis regimens for preventing surgical site infections following colorectal surgery in adult patients.

Methods: We will search the Medline, EMBASE, CINAHL, Scopus, and Cochrane Central Register of Controlled Trials databases to identify relevant randomized controlled trials. We will include trials that (1) enrolled adults who underwent colorectal surgeries and (2) randomized them to any systemic administration of antibiotic (single or combined) prophylaxis before surgery compared to an alternative systemic antibiotic (single or combined antibiotic), placebo, control, or no prophylactic treatment. Pairs of reviewers will independently assess the risk of bias among eligible trials using a modified Cochrane risk of bias instrument for randomized trials. Our outcomes of interest include the rate of surgical site infection within 30 days of surgery, hospital length of stay, 30-day mortality, and treatment-related adverse effects. We will perform a contrast-based network meta-analysis using a frequentist random-effects model assuming a common heterogeneity parameter. The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach will be utilized to assess the certainty of evidence for treatment effects.

Discussion: By synthesizing evidence from available RCTs, this study will provide valuable insight for clinicians, patients, and health policymakers on the most effective antibiotics for preventing surgical site infection.

Systematic review registration: PROSPERO CRD42023434544.

Retraction: L. Liu , M. Zhang , X. Zhang , and Q. Xiang , "Effects of enhance recovery after surgery nursing program on the surgical site wound infection in patients undergoing laparoscopic hepatectomy for hepatocellular carcinoma: A meta-analysis," Int Wound J 21, no. 3 (2023): e14490, https://doi.org/10.1111/iwj.14490. The above article, published online on 16 November 2023, in Wiley Online Library (http://onlinelibrary.wiley.com/), has been retracted by agreement between the journal Editor in Chief, Professor Keith Harding; and John Wiley & Sons, Ltd. It came to the publisher's attention from a third party that a number of articles shared concerning similarities in format and structure. Following an investigation by the publisher, the retraction of this article has been agreed on because the peer review and publishing process for this article were found to have been manipulated. The authors did not respond to our notice of retraction.

» We aimed to determine the cost-effectiveness of different protocols of extended postoperative antibiotic prophylaxis (E-PAP) following adult spinal surgery.

» Both stratified (randomized controlled trials only) and nonstratified (all studies) analyses demonstrated that E-PAP has no significant value in reducing the rate of surgical site infection (SSI), deep SSI, or superficial SSI.

» Notably, the E-PAP protocols were associated with a significant increase in the length of hospital stay, resulting in an additional expenditure of $244.4 per episode for the E-PAP 72 hours protocol compared with PAP 24 hours and $309.8 per episode for the E-PAP >48 hours protocol compared with PAP <48 hours.

» E-PAP does not demonstrate any significant reduction in the rate of SSIs following spine surgery. However, these extended protocols were significantly associated with an increase in the length of hospital stay and higher overall projected costs.

Objective: Cold atmospheric plasma (CAP) has shown an ability to promote wound healing by modulating biological processes without causing thermal damage. This scoping review aimed to evaluate the effectiveness of CAP application in the oral wound healing process.

Design: An electronic literature search was conducted using PubMed/Medline, Embase, Web of Science, Scopus, and grey literature (Google Scholar). The search included all articles published up to October 11, 2023. Only studies focusing on the different CAP types' effects on oral cavity wounds or cells were included in the review.

Results: This review analyzed 13 studies including seven cell culture studies, one animal study, and five human studies (three in vivo and two ex vivo). The findings from the reviewed articles suggest that CAP may have therapeutic potential. It can maintain cell viability and influence gene expression, accelerate wound healing, and modulate inflammation-related cytokines. DBD plasma exhibited time-sensitive effects on cellular behavior and microplasma irradiation positively impacted cell count, biochemical profiles, and cellular migration.

Conclusion: The application of CAP has been shown to have a positive impact on the healing of oral wounds in cell culture, animal, and human studies.

Wound development and healing involve intricate genetic and molecular processes, posing significant clinical management challenges. The objective of this study was to assess commonly used fat extracts' efficacy and safety (autologous fat, stromal vascular fraction and adipose-derived stem cells) in wound healing, particularly for refractory wounds, with the goal of providing evidence in clinical use. After a systematic review, 21 randomised controlled trials were included in our study. Based on the classification of human fat products, our meta-analysis revealed that the use of human fat products could speed healing rate, shorten healing time and achieve more complete healing, with statistically significant differences in outcome indicators when compared to conventional treatments. The analysis of histological findings across various studies indicated that fat extracts can promote epithelialization, collagen deposition and vascularization, thereby facilitating tissue regeneration and reducing inflammatory reactions. There were potential benefits to reducing patient pain levels after using adipose extracts. Furthermore, we analysed and summarised adverse events indicating the safe and effective clinical use of human fat products in wound treatment. Our research findings supported the efficiency of human fat products and demonstrated a high degree of safety in the clinical practice of wound management.

Background: Linear closure (LC) following stoma reversal is associated with a high risk of surgical site infection (SSI). Purse-string closure and LC were both positive for the closure of the skin wound following stoma reversal, and it was not yet possible to distinguish which one was more beneficial to the patient's prognosis.

Methods: We conducted a search in Embase, PubMed, Web of Science, and Cochrane Library and conducted a randomized controlled experiment from the inception of each database to July 2024. Among them, the SSI within 30 days, operation time, hospitalization time, incisional hernia, and wound healing time were all outcome indicators.

Results: Eleven studies were included in this meta-analysis (506 patients in the purse-string closure group and 489 patients in the LC group). The pooled data showed that the SSI rate was significantly lower in the purse-string closure group than in the LC group (odds ratio, 0.15; 95% confidence interval, 0.09-0.24; P < .00001; I2 = 0%). The differences in operative time, hospitalization time, incision hernia, and wound healing time were not statistically significant.

Conclusion: Overall, purse-string closure had a significantly lower SSI rate following stoma reversal than LC.

Introduction: The purpose of this protocol is to investigate the risk factors, critical evaluation contents and preventive measures of high-output enterostomy.

Methods and analysis: This scoping review will follow the Joanna Briggs Institute guidelines for scoping reviews. PubMed, EMBASE, CINAHL, the Chinese Biological Literature Database and the Cochrane Library will be searched for relevant literature published from January 2015 to January 2024. The Grading of Recommendations, Assessment, Development and Evaluation and the Risk Of Bias In Non-randomised Studies of Interventions will be used to assess the reliability of the evidence.

Ethics and dissemination: As this scoping review involves database searches for literature analysis, informed consent and ethical approval from patients will not be required. The findings will provide essential decision-making information for researchers, clinicians and ostomy nursing staff. The results of the review will be presented at a scientific conference and published in a peer-reviewed journal.

This systematic review critically evaluates preclinical and clinical data on the antibacterial and wound healing properties of cannabinoids in integument wounds. Comprehensive searches were conducted across multiple databases, including CINAHL, Cochrane library, Medline, Embase, PubMed, Web of Science, and LILACS, encompassing records up to May 22, 2024. Eighteen studies met the inclusion criteria. Eleven were animal studies, predominantly utilizing murine models (n = 10) and one equine model, involving 437 animals. The seven human studies ranged from case reports to randomized controlled trials, encompassing 92 participants aged six months to ninety years, with sample sizes varying from 1 to 69 patients. The studies examined the effects of various cannabinoid formulations, including combinations with other plant extracts, crude extracts, and purified and synthetic cannabis-based medications administered topically, intraperitoneally, orally, or sublingually. Four animal and three human studies reported complete wound closure. Hemp fruit oil extract, cannabidiol (CBD), and GP1a resulted in complete wound closure in twenty-three (range: 5-84) days with a healing rate of 66-86% within ten days in animal studies. One human study documented a wound healing rate of 3.3 cm² over 30 days, while three studies on chronic, non-healing wounds reported an average healing time of 54 (21-150) days for 17 patients by oral oils with tetrahydrocannabinol (THC) and CBD and topical gels with THC, CBD, and terpenes. CBD and tetrahydrocannabidiol demonstrated significant potential in reducing bacterial loads in murine models. However, further high-quality research is imperative to fully elucidate the therapeutic potential of cannabinoids in the treatment of bacterial skin infections and wounds. Additionally, it is crucial to delineate the impact of medicinal cannabis on the various phases of wound healing. This study was registered in PROSPERO (CRD42021255413).

Although there have been numerous advancements in burn wound management, burn injuries are still a major cause of morbidity and mortality in the United States and novel therapeutic are still needed to improve outcomes. Poloxamer 188 (P188) is a synthetic copolymer with FDA approval that has many biological applications. This study aimed to review the literature on P188 in burn injuries and its effects based on burn mechanisms. We employed the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines to complete this systematic literature review. We searched the databases of Google Scholar, PubMed, and SCOPUS using the keywords burn, p188, poloxamer 188, and pluronic F68 in combination. Two reviewers independently screened the articles for inclusion. Articles that were not in English, were book chapters or conference proceedings, or did not evaluate P188 in the setting of burn injuries were excluded. We included a total of 33 full-text articles with both in vivo and in vitro pre-clinical studies. P188 was found to beneficial in animal and cell studies evaluating electrical and thermal burn injuries. P188 was also found to be useful in burn wound management. Although its utility may be limited in radiation injuries, P188 may be helpful in delaying the initial damage caused by radiation burns. P188 therefore has the potential to be used as a therapy in both burn wound management and in the treatment of systemic injuries sustained through burns. Future studies should aim to assess the efficacy of P188 in clinical models of burn injury.

Objectives: Diode laser represent a practical clinical strategy for treating gingival hyperpigmentation. However, its effectiveness remains controversial. We conducted a meta-analysis evaluating the quantitative effects of diode laser therapy on gingival hyperpigmentation.

Method and materials: Pubmed, Embase, Web Of Science, and Cochrane Library were systematically searched for the use of diode laser in gingival hyperpigmentation. The primary outcomes assessed were the Dummett-Gupta Oral Pigmentation Index (DOPI), Visual Analog Scale (VAS) pain scores, and the Wound Healing Index (WHI) for overall evaluation. I2 index was calculated to identify heterogeneity and sensitivity analyses sources of heterogeneity. Funnel plots and Egger's test were utilized to evaluate publication bias.

Results: Thirteen randomized controlled trials (RCTs) involving a total of 233 participants were included in this study. The analysis demonstrated that diode laser had a significant effect on DOPI (standard mean difference [SMD] &#61; -0.245, 95% CI &#61; -0.415 to -0.040, P &#61;.019) and VAS (SMD &#61; -0.089, 95% CI &#61; -1.332 to -0.285, P &#61;.002), with no significant effect on WHI (SMD &#61; -0.224, 95% CI &#61; -1.100 to 0.653, P &#61;.617). Despite the significant heterogeneity in VAS and WHI indicated by the I2 index statistic, the sensitivity analyses' results demonstrated the main findings' reliability. While no significant publication bias was detected for DOPI and WHI, the VAS results exhibited notable publication bias.

Conclusion: The study demonstrated that diode laser prolongs gingival repigmentation time and reduces pain compared to other treatments. However, the efficacy in wound healing did not significantly promote.

Objective: We sought to characterize and evaluate the effectiveness of pharmacist-led AMS interventions in improving antimicrobial use and subsequent surgical site infections (SSI) in perioperative settings.

Methods: A systematic review and meta-analysis was conducted by searching PubMed, Embase and CINAHL. Two independent reviewers extracted the data using the Descriptive Elements of Pharmacist Intervention Characterization Tool and undertook quality assessment using the Crowe Critical Appraisal. A meta-analysis was conducted using a random-effect model.

Results: Eleven studies were included in this review. Pharmacists were found to have various roles in AMS, including educational sessions, ward rounds, audits and feedback, and guidelines development. The discussion of interventions lacked details on the development. A meta-analysis revealed that pharmacist-led AMS programs in perioperative settings was associated with a significant improvement in antibiotic selection (OR 4.29; 95 % CI 2.52-7.30), administration time (OR 4.93; 95 % CI 2.05-11.84), duration (OR 5.27; 95 % CI 1.58-17.55), and SSI (OR 0.51; 95 % CI 0.34-0.77).

Conclusion: Pharmacist-led AMS programs were effective in improving antimicrobial prescribing while reducing SSI; however most studies were of moderate quality. Studies lacked the utilization of theory to develop interventions, therefore, it is not clear whether theory-derived interventions are more effective than those without a theoretical element. High-quality, multicomponent, theory-derived, interventional studies using appropriate methodology and standardized data collection, are needed.

Background: The perioperative use of dexamethasone in diabetic patients remains controversial due to concerns related to infection and adverse events. This study aimed to determine whether clinical evidence supports withholding dexamethasone in diabetic patients due to concern for infection risk. We hypothesized that there is no difference in infectious outcomes between dexamethasone-treated patients and controls.

Methods: A literature search was performed on November 22, 2022 to identify randomized, placebo-controlled trials investigating short-course (<72 hours), perioperative dexamethasone that explicitly included diabetic patients and measured at least 1 clinical outcome. Pertinent studies were independently searched in PubMed, Embase, and Cochrane. Authors for all identified studies were contacted with the aim of performing quantitative subgroup analyses of diabetic patients. The primary end point was surgical site infection and the secondary end point was a composite of adverse events. Qualitative remarks were reported based on the total available data and a quality assessment tool. Meta-analyses were performed using inverse variance with random effects. Heterogeneity was assessed via standard χ2 and I2 tests.

Results: Sixteen unique studies were included, 5 of which were analyzed quantitatively. Of the 2592 diabetic patients, 2344 (1184 randomized to dexamethasone and 1160 to placebo) were analyzed in at least 1 quantitative outcome. Quantitative analysis showed that the use of perioperative dexamethasone had no effect on the risk of surgical site infections (log odds ratio [LOR], -0.10, 95%; 95% confidence interval [CI], -0.64 to 0.44) while significantly reducing the risk of composite adverse events (LOR, -0.33; 95% CI, -0.62 to -0.05). Qualitative analysis reinforced these findings, demonstrating noninferior to superior results across all clinical outcomes. There was high heterogeneity between the included studies.

Conclusions: Current evidence suggests perioperative dexamethasone may be given to diabetic patients without increasing the risk of infectious complications. Prospective investigations aimed at optimizing dose, frequency, and timing are needed, as well as studies aimed explicitly at exploring the use of dexamethasone in patients with poorly controlled diabetes.

Objective: To evaluate the effects of silver and iodine dressings on healing time, healing rate, exudate amount, pain and anti-infective efficacy.

Design: Systematic review and meta-analysis.

Data sources: Databases including PubMed, Cochrane Library, Embase, Web of Science and CINAHL were surveyed up to May 2024.

Eligibility criteria: Randomised controlled trials comparing silver and iodine dressings on wound healing in humans.

Data extraction and synthesis: Evidence certainty was evaluated using the Grading of Recommendations, Assessment, Development, and Evaluation approach. Data extraction was done independently by two reviewers, with the risk of bias assessed using the Cochrane tool. Narrative synthesis was performed to evaluate the effects of silver and iodine dressings on healing time, healing rate, pain, exudate amount and anti-infective efficacy. Meta-analysis using Review Manager V.5.4 calculated standardised mean differences for healing time and relative risks for rate to quantify the impacts of the treatments.

Results: 17 studies (18 articles) were included. The meta-analysis indicated that silver dressings significantly reduced healing time compared with iodine dressings (SMD=-0.95, 95% CI -1.62 to -0.28, I²=92%, p=0.005, moderate-quality evidence), with no significant difference in enhancing healing rate (RR=1.29, 95% CI 0.90 to 1.85, I²=91%, p=0.16, low-quality evidence). Based on low-quality evidence, for exudate amount (3/17), 66.7% (2/3) of the studies favoured silver dressings over iodine in reducing exudate volume. For pain (7/17), 57.1% (4/7) of the studies reported no significant difference between silver and iodine dressings, while 42.9% (3/7) studies indicated superior pain relief with silver dressings. For anti-infective efficacy (11/13), 54.5% (6/11) of the studies showed equivalence between silver and iodine dressings, while 36.4% (4/11) suggested greater antibacterial efficacy for silver.

Conclusion: Silver dressings, demonstrating a comparable healing rate to iodine dressings, significantly reduce healing time, suggesting their potential as a superior adjunct in wound care.

Prospero registration number: CRD42020199602.

Objective: Wound infection after intestinal ostomy closure is common postoperative complication. An alternative to primary suturing (PS) of the wound is incisional negative pressure wound therapy (iNPWT). The aim of the article was to assess and compare clinical outcomes after PS and iNPWT.

Approach: Strategy was aimed to find relevant data comparing outcomes of iNPWT and PS after ostomy closure. Search was conducted using the MEDLINE/PubMed, ScienceDirect, EMBASE, Scopus, Cochrane Controlled Register of Trials, SciELO, and Web of Science databases. Authors conducted a meta-analysis of parameters: wound healing time, surgical site infections, complications, length of stay.

Results: The analysis revealed that iNPWT and control group did not differ significantly in wound healing time (OR = -2.06; 95% CI = -5.99-1.87; p=0.30, I2=4%). Meta-analysis of surgical site infection incidence revealed a significant difference favoring the incisional NPWT group versus observational (OR = 0.42; 95% CI = 0.25-0.72; p=0.002; I2=14%). Patients in iNPWT group had significantly lower incidence of complications than observational group (OR = 0.52; 95% CI = 0.35-0.77; p=0.001, I2=71%). Subgroup analysis limited to randomized studies only also presented significant differences favoring the iNPWT group against observational (OR = 0.27; 95% CI = 0.14-0.52; p<0.001, I2=67%). Our analysis revealed that LOS was not significantly different between groups among patients treated with iNPWT (IV=0.19; 95% CI = -0.66 -1,04; p=0.76, I2=0%). Subgroup analysis of randomized studies also did not present a significant difference (IV=0.25; 95% CI = -0.80 -1,30; p=0.33, I2=10%).

Innovation: Study shows that the use of iNPWT can reduce surgical site infections with other complications (wound hematomas, wound seromas, wound dehiscence, fistulas, ileus) in patients undergoing intestinal ostomy closure without extended hospital stay.

Conclusions: Use of iNPWT can be considered in postoperative care after elective ostomy closure to decrease the rate of the most common complication after ostomy closure.

Xu Q, Li Z. Effects of pneumatic compression therapy on wound healing in patients with venous ulcers: a meta-analysis. Int Wound J. 2023; 21(3): e14438. 10.1111/iwj.14438 The above article, published online on 07 November 2023, in Wiley Online Library (http://onlinelibrary.wiley.com/), has been retracted by agreement between the journal Editor in Chief, Professor Keith Harding; and John Wiley & Sons, Ltd. It came to the publisher's attention from a third party that a number of articles shared concerning similarities in format and structure. Following an investigation by the publisher, the retraction of this article has been agreed on because the peer review and publishing process for this article were found to have been manipulated. The authors did not respond to our notice of retraction.

Lu H, Yu J, Hong H. Effects of an enhanced recovery after surgery nursing programme on surgical site wound infection and postoperative complications in patients undergoing total knee arthroplasty: a meta-analysis. Int Wound J. 2023; 21(3): e14485, doi: 10.1111/iwj.14485 The above article, published online on 16 November 2023, in Wiley Online Library (http://onlinelibrary.wiley.com/), has been retracted by agreement between the journal Editor in Chief, Professor Keith Harding; and John Wiley & Sons, Ltd. It came to the publisher's attention from a third party that a number of articles shared concerning similarities in format and structure. Following an investigation by the publisher, the retraction of this article has been agreed on because the peer review and publishing process for this article were found to have been manipulated. The authors did not respond to our notice of retraction.