Effectiveness of iodine-impregnated incise drapes for preventing surgical site infection in patients with clean or clean contaminated wounds: A systematic literature review and cost-consequence analysis.

The included studies were too different in design, surgery type, infection definition, timing and quality to combine into one answer. Most studies were non-randomised, and the review included only two randomised trials. The randomised trial with a no-drape comparator had a high risk of bias, and several non-randomised studies had serious risk of bias. Patients received different perioperative care, including antibiotics in six studies, so baseline care may have affected infection rates. The cost saving was based on one non-randomised cardiac study and assumed costs, so it does not prove clinical benefit for all surgery. The main search stopped on 28 February 2019, although a later PubMed check found no additional relevant publications.

The work was supported by 3M. Some authors were employed by 3M, and the University of Sheffield received an unrestricted grant from 3M. The academic authors stated they worked independently and were responsible for study design, data collection, analysis and writing.

Do not read the £554 saving per patient as proof that iodine-impregnated drapes are effective for all surgery. The saving came from a model based on one non-randomised cardiac study, and the review rated the clinical evidence as very low.