Evaluating the Effectiveness of Gentamicin-Impregnated Collagen Sponge in the Prevention of Surgical Site Infection in Colorectal Surgery: A Systematic Literature Review and Meta-Analysis.

Surgical site infection (SSI) is a frequent postoperative complication, particularly in colorectal surgeries, which exhibit higher SSI rates than other procedures. The application of Gentamicin-Collagen Implant (GCI) at a local surgical site maximises not only the unique qualities of collagen in enhancing wound healing but also the antibacterial effects of gentamicin. The objective of this study is to determine if SSI is reduced by the use of GCI during colorectal procedures. Included studies were randomised controlled trials (RCTs) comparing GCI use with a defined control in colorectal surgeries. Exclusions comprised non-RCTs, case reports, animal studies, non-colorectal surgery comparisons, and studies lacking relevant endpoints. Literature searches were conducted in January 2025 using the SCOPUS, PubMed, Embase, and Cochrane Library medical databases. Risk of bias was assessed with the Rob2 tool (Cochrane Collaboration, Oxford, UK), and a meta-analysis was conducted using Review Manager (Cochrane Collaboration). Endpoints included incisional SSI, primary wound healing, and disease recurrence. Fourteen RCTs with 2,233 patients (1,114 with and 1,119 without GCI) were analysed. GCI significantly lowered overall SSI incidence (RR = 0.54; CI = 0.35-0.85; p = 0.007) and specifically in rectal surgeries (RR = 0.56; CI = 0.39-0.81; p = 0.002). No significant effect was observed in pilonidal disease surgeries (RR = 0.34; CI = 0.09-1.23; p = 0.10) or its recurrence (RR = 0.62; CI = 0.09-4.57; p = 0.64). GCI effectively reduces SSI in rectal surgeries but not in pilonidal disease operations. Routine GCI may reduce SSI in rectal surgery.