Antimicrobial Incise Drapes in Knee and Hip Arthroplasties: Meta-analysis of Randomized Controlled and Prospective Cohort Studies

Traditional skin preparation and prophylactic antibiotics have not uniformly been successful in preventing surgical site infection (SSI) following total joint arthroplasties. Iodophor-impregnated adhesive dressings, such as Ioban, have shown promising effects in reducing the incidence of SSI. A systematic review and meta-analysis were conducted according to PRISMA checklist and the Cochrane Handbook for Systematic Reviews of Interventions. Non-stratified and stratified meta-analysis were conducted to test for confounding and biases. The methodological quality and risk of bias were analyzed and appraised. Five studies including 1,655 patients were eligible. In these studies, 51.6% of the included patients had antimicrobial incise drape in the setting of knee and hip arthroplasties. Both non-stratified and stratified analyses revealed that the antimicrobial incise drape significantly reduced the risk of contamination as compared with no drape (odds ratio = 0.54, p < 0.0001). Iodophor- impregnated incise drapes, such as Ioban, significantly reduce the risk of contamination in total joint arthroplasties. (Journal of Surgical Orthopaedic Advances 33(4):206-211, 2024)

Key words: antimicrobial incise drape, surgical site complications, Ioban, contamination, knee arthroplasty, hip arthroplasty