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Methodological quality graph: review authors' judgements about each methodological quality item presented as percentages across all included studies.
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Figure 1

Methodological quality graph: review authors' judgements about each methodological quality item presented as percentages across all included studies.

Methodological quality summary: review authors' judgements about each methodological quality item for each included study.
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Figure 2

Methodological quality summary: review authors' judgements about each methodological quality item for each included study.

Comparison 1 Adhesive drapes versus no adhesive drapes, Outcome 1 Surgical site infection (all wound classifications).
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Analysis 1.1

Comparison 1 Adhesive drapes versus no adhesive drapes, Outcome 1 Surgical site infection (all wound classifications).

Comparison 1 Adhesive drapes versus no adhesive drapes, Outcome 2 Surgical site infection (by wound classification).
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Analysis 1.2

Comparison 1 Adhesive drapes versus no adhesive drapes, Outcome 2 Surgical site infection (by wound classification).

Comparison 1 Adhesive drapes versus no adhesive drapes, Outcome 3 Length of hospital stay.
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Analysis 1.3

Comparison 1 Adhesive drapes versus no adhesive drapes, Outcome 3 Length of hospital stay.

Comparison 2 Iodine‐impregnated adhesive drapes versus no adhesive drapes, Outcome 1 Surgical site infection.
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Analysis 2.1

Comparison 2 Iodine‐impregnated adhesive drapes versus no adhesive drapes, Outcome 1 Surgical site infection.

Adhesive drapes compared with no adhesive drapes for preventing surgical site infection

Patient or population: Patients undergoing surgery
Settings: Hospital
Intervention: Adhesive drapes

Comparison: No adhesive drapes

Outcomes

Illustrative comparative risks* (95% CI)

Relative effect
(95% CI)

No. of Participants
(studies)

Quality of the evidence
(GRADE)

Comments

Assumed risk

Corresponding risk

Control

Adhesive drapes versus no adhesive drapes

Surgical site infection (all wound classifications)
Inspection of the wound1
(follow‐up: 5 to 24 weeks2)

Medium risk population

RR 1.23
(1.02 to 1.48)

3082
(5)

⊕⊕⊕⊕
High3,4

109 per 1000

134 per 1000
(111 to 161)

*The basis for the assumed risk (e.g. the median control group risk across studies) is provided in footnotes. The corresponding risk (and its 95% CI) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI).
CI: Confidence interval; RR: Risk ratio

GRADE Working Group grades of evidence
High quality: Further research is very unlikely to change our confidence in the estimate of effect.
Moderate quality: Further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate.
Low quality: Further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate.
Very low quality: We are very uncertain about the estimate.

1 Various definitions of infection were used; we accepted the authors definition in each case.
2 In one trial (Psaila 1977) the follow‐up period was not nominated.
3 Generation of random allocation sequence was unclear in two trials (Chiu 1993; Psaila 1977). Allocation concealment was unclear in four trials (Chiu 1993; Cordtz 1989; Jackson 1971; Psaila 1977). Outcome assessment was blinded in only one of the five studies (Ward 2001). However, although information about these quality issues were not available for some trials, results were similar across trials so we do not believe results were compromised by these omissions in reporting.
4 The total sample met requirements for optimal information size, and the total number of events exceeded 300.

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Iodophore‐impregnated adhesive drapes compared with no adhesive drapes for preventing surgical site infection

Patient or population: Patients undergoing surgery
Settings: Hospital
Intervention: Iodophore‐impregnated adhesive drapes
Comparison: No adhesive drapes

Outcomes

Illustrative comparative risks* (95% CI)

Relative effect
(95% CI)

No. of Participants
(studies)

Quality of the evidence
(GRADE)

Comments

Assumed risk

Corresponding risk

No adhesive drapes

Iodophore‐impregnated adhesive drapes

Surgical site infection
Inspection of the wound1
(follow‐up: 3 to 6 weeks)

Medium risk population

RR 1.03
(0.66 to 1.6)

1113
(2)

⊕⊕⊕⊝
Moderate2,3

45 per 1000

46 per 1000
(30 to 72)

*The basis for the assumed risk (e.g. the median control group risk across studies) is provided in footnotes. The corresponding risk (and its 95% CI) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI).
CI: Confidence interval; RR: Risk ratio

GRADE Working Group grades of evidence
High quality: Further research is very unlikely to change our confidence in the estimate of effect.
Moderate quality: Further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate.
Low quality: Further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate.
Very low quality: We are very uncertain about the estimate.

1 A number of definitions of wound infection were used across the trials. We accepted the authors definition in all cases.
2 Although information about allocation concealment was unclear in one trial (Dewan 1987) and outcome assessment was not blinded in the Segal 2002 trial, we have judged that this has not compromised the result.
3 There was imprecision on at least two counts; the total sample size was too small to meet optimal information size, and the total number of events was less than 300.

Figuras y tablas -
Comparison 1. Adhesive drapes versus no adhesive drapes

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Surgical site infection (all wound classifications) Show forest plot

5

3082

Risk Ratio (M‐H, Fixed, 95% CI)

1.23 [1.02, 1.48]

2 Surgical site infection (by wound classification) Show forest plot

1

921

Risk Ratio (M‐H, Fixed, 95% CI)

1.20 [0.86, 1.66]

2.1 Clean

1

363

Risk Ratio (M‐H, Fixed, 95% CI)

1.37 [0.53, 3.53]

2.2 Potentially infected

1

486

Risk Ratio (M‐H, Fixed, 95% CI)

1.24 [0.80, 1.92]

2.3 Infected

1

72

Risk Ratio (M‐H, Fixed, 95% CI)

1.03 [0.60, 1.75]

3 Length of hospital stay Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Totals not selected

3.1 Infected wound

1

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

3.2 No infected wound

1

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

Figuras y tablas -
Comparison 1. Adhesive drapes versus no adhesive drapes
Comparison 2. Iodine‐impregnated adhesive drapes versus no adhesive drapes

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Surgical site infection Show forest plot

2

1113

Risk Ratio (M‐H, Fixed, 95% CI)

1.03 [0.66, 1.60]

Figuras y tablas -
Comparison 2. Iodine‐impregnated adhesive drapes versus no adhesive drapes