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

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.

To evaluate the efficacy of silver-based dressings compared with non-silver dressings in preventing SSIs in randomized controlled trials (RCTs).

A systematic search was conducted in PubMed, Cochrane Library and Embase to identify RCTs comparing silver-based dressings with non-silver dressings for the prevention of SSIs. The study protocol was registered in PROSPERO (CRD42024592966). Meta-analysis using a random-effects model calculated pooled risk ratios (RR) with 95% confidence intervals (CI). Heterogeneity was assessed with the I² statistic, and publication bias was evaluated through funnel plots and Egger's test.

Twelve RCTs with 2928 participants were included in the meta-analysis. Silver-based dressings reduced the risk of SSIs by 40% compared with non-silver dressings (RR 0.60, 95% CI 0.41-0.89; P<0.05); this difference was significant. Heterogeneity was moderate (I²=53%).

Silver-based dressings reduce the risk of SSIs significantly; however, further high-quality RCTs are needed to confirm their benefits across different surgical contexts and patient populations.