scholarly journals Clinical Efficacy of Perioperative Immunonutrition Containing Omega-3-Fatty Acids in Patients Undergoing Hepatectomy: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

2020 ◽  
pp. 1-12
Author(s):  
Benjian Gao ◽  
Jia Luo ◽  
Ying Liu ◽  
Furui Zhong ◽  
Xiaoli Yang ◽  
...  
Keyword(s):  
Postoperative Complications ◽  
Hospital Stay ◽  
Randomized Controlled Trials ◽  
Fixed Effects ◽  
Meta Analysis ◽  
Length Of Hospital Stay ◽  
Cochrane Library ◽  
Controlled Trials ◽  
Randomized Controlled ◽  
The Impact

<b><i>Background:</i></b> The effect of immunonutrition in patients undergoing hepatectomy remains unclear. This meta-analysis aimed to assess the impact of immunonutrition on postoperative clinical outcomes in patients undergoing hepatectomy. <b><i>Methods:</i></b> A literature search of PubMed, Cochrane Library, Web of Science, and Embase databases was performed to identify all randomized controlled trials (RCTs) exploring the effect of perioperative immunonutrition in patients undergoing hepatectomy until the end of March 10, 2020. Quality assessment and data extraction of RCTs were conducted independently by 3 reviewers. Mean difference (MD) and odds ratio (OR) with 95% confidence interval (CI) were calculated using a fixed-effects or random-effects model. The meta-analysis was performed with RevMan 5.3 software. <b><i>Results:</i></b> Nine RCTs involving a total of 966 patients were finally included. This meta-analysis showed that immunonutrition significantly reduced the incidences of overall postoperative complications (OR = 0.57, 95% CI: 0.34–0.95; <i>p</i> = 0.03), overall postoperative infectious complications (OR = 0.53, 95% CI: 0.37–0.75; <i>p</i> = 0.0003), and incision infection (OR = 0.50, 95% CI: 0.28–0.89; <i>p</i> = 0.02), and it shortened the length of hospital stay (MD = −3.80, 95% CI: −6.59 to −1.02; <i>p</i> = 0.007). There were no significant differences in the incidences of pulmonary infection (OR = 0.60, 95% CI: 0.32–1.12; <i>p</i> = 0.11), urinary tract infection (OR = 1.30, 95% CI: 0.55–3.08; <i>p</i> = 0.55), liver failure (OR = 0.54, 95% CI: 0.23–1.24; <i>p</i> = 0.15), and postoperative mortality (OR = 0.69, 95% CI: 0.26–1.83; <i>p</i> = 0.46). <b><i>Conclusion:</i></b> Given its positive impact on postoperative complications and the tendency to shorten the length of hospital stay, perioperative immunonutrition should be encouraged in patients undergoing hepatectomy.

Effects of Enteral Immunonutrition in Patients Undergoing Pancreaticoduodenectomy: A Meta-Analysis of Randomized Controlled Trials

2018 ◽  
Vol 74 (1) ◽  
pp. 53-61 ◽  
Author(s):  
Haonan Guan ◽  
Sanwei Chen ◽  
Qiang Huang
Keyword(s):  
Hospital Stay ◽  
Randomized Controlled Trials ◽  
Fixed Effects ◽  
Meta Analysis ◽  
Postoperative Mortality ◽  
Length Of Hospital Stay ◽  
Infectious Complications ◽  
Controlled Trials ◽  
Randomized Controlled ◽  
The Impact

Background: The effect of enteral immunonutrition (EIN) in patients undergoing pancreaticoduodenectomy (PD) is still doubtful. This meta-analysis aimed to assess the impact of EIN on postoperative clinical outcomes for patients undergoing PD. Methods: A literature search was carried out to identify all of the randomized controlled trials (RCTs) concerning the use of EIN for PD. Data collection ended on April 1, 2018. Pooled risk ratios (RRs) and the mean difference (MD) with a 95% CI were calculated using fixed effects or random effects models. The analyses were performed with RevMan 5.3.5. Results: Four RCTs with a total of 299 patients were included. Immunonutrition reduced the incidence of postoperative infectious complications (RR 0.58, 95% CI 0.37–0.92; p = 0.02) and shortened the length of hospital stay (MD –1.79, 95% CI –3.40 to 0.18; p = 0.03). Conversely, there were no significant differences in the incidence of overall postoperative complications (RR 0.81, 95% CI 0.62–1.05; p = 0.11), non-infectious complications (RR 0.94, 95% CI 0.69–1.28; p = 0.70) and postoperative mortality (RR 2.43, 95% CI 0.37–16.10; p = 0.36). Conclusions: EIN reduced postoperative infectious complications and shortened the length of the hospital stay; immunonutrition should be encouraged in patients undergoing PD.

scholarly journals Poly(ADP-Ribose) Polymerase Inhibitors (PARPi) for Patients With Advanced Breast Cancer: a Meta-analysis of Randomized Controlled Trials

2020 ◽  
Author(s):  
YongCheng Su ◽  
XiaoGang Zheng
Keyword(s):  
Breast Cancer ◽  
Randomized Controlled Trials ◽  
Fixed Effects ◽  
Meta Analysis ◽  
Parp Inhibitors ◽  
Cochrane Library ◽  
Controlled Trials ◽  
Randomized Controlled ◽  
Increased Risk ◽  
Grade 3

Abstract BACKGROUND: Poly(ADP–ribose) polymerase (PARP) inhibitors are new class of drugs that are currently being studied in several malignancies. However, datas about the efficacy and safety of the PARP inhibitors are limited. Therefore, we conducted a meta-analysis of randomized controlled trials (RCT) in patients with breast cancer.METHODS: Pubmed/Medline, Embase, Cochrane Library, and abstracts presented at the annual meeting of the American Society of Clinical Oncology (ASCO) were searched for articles published from 2000 to June 2018.Summary incidences and the RR, HR with 95% confidence intervals, were calculated by using a random-effects or fixed-effects model.RESULTS: The summary HR indicated PARPi was not associated with OS (HR=0.83, 95%CI 0.66–1.06, Z=1.49, P=0.14), while it could significantly improve PFS ande time to deterioration (TTD) of global health status/quality of life(GHS/QoL) as compared with traditional standard therapy, the HR was 0.60(95%CI 0.50-0.72; Z=5.52, P＜0.00001) and 0.4 (95%CI 0.29–0.54,z=5.80 ,p=0.000),respectively.The RR of grade 3 or more anemia ,fatigue and headache was 3.02 (95% CI, 0.69–13.17;p = 0.14,,I2=90%),0.77 (95%CI, 0.34–1.73;p=0.52,I2=7%) and 1.13 (95% CI,0.30–4.18;p=0.86,I2=0%),respectively.CONCLUSION: The findings of this meta-analysis showed that PARPi has no significant effect on OS, while it could significantly improve in PFS and TTD of GHS/QoL for patients with advanced or metastatic breast cancer.Furthermore,our findings also demonstrated that the PARPi treatment is connected with an increased risk of grade 3 or more anemia adverse events.

scholarly journals The Long-Lasting Effects of “Placebo Injections” in Knee Osteoarthritis: A Meta-Analysis

Cartilage ◽  
2020 ◽  
pp. 194760352090659 ◽  
Author(s):  
Davide Previtali ◽  
Giulia Merli ◽  
Giorgio Di Laura Frattura ◽  
Christian Candrian ◽  
Stefano Zaffagnini ◽  
...  
Keyword(s):  
Knee Osteoarthritis ◽  
Randomized Controlled Trials ◽  
Placebo Effect ◽  
Meta Analysis ◽  
Grey Literature ◽  
Cochrane Library ◽  
Controlled Trials ◽  
Level Of Evidence ◽  
Randomized Controlled ◽  
The Impact

Objectives To quantify the placebo effect of intraarticular injections for knee osteoarthritis in terms of pain, function, and objective outcomes. Factors influencing placebo effect were investigated. Design Meta-analysis of randomized controlled trials; Level of evidence, 2. PubMed, Web of Science, Cochrane Library, and grey literature databases were searched on January 8, 2020, using the string: (knee) AND (osteoarthritis OR OA) AND (injections OR intra-articular) AND (saline OR placebo). The following inclusion criteria were used: double-blind, randomized controlled trials on knee osteoarthritis, including a placebo arm on saline injections. The primary outcome was pain variation. Risk of bias was assessed using the RoB 2.0 tool, and quality of evidence was graded following the GRADE (Grading of Recommendations Assessment, Development and Evaluation) guidelines. Results Out of 2,363 records, 50 articles on 4,076 patients were included. The meta-analysis showed significant improvements up to the 6-month follow-up: Visual Analogue Scale (VAS)-pain −13.4 mean difference (MD) (95% confidence interval [CI]: −21.7/−5.1; P < 0.001), Western Ontario and McMaster Osteoarthritis Index (WOMAC)-pain −3.3 MD (95% CI: −3.9/−2.7; P < 0.001). Other significant improvements were WOMAC-stiffness −1.1 MD (95% CI: −1.6/−0.6; P < 0.001), WOMAC-function −10.1 MD (95% CI: −12.2/−8.0; P < 0.001), and Evaluator Global Assessment −21.4 MD (95% CI: −29.2/−13.6; P < 0.001). The responder rate was 52% (95% CI: 40% to 63%). Improvements were greater than the “minimal clinically important difference” for all outcomes (except 6-month VAS-pain). The level of evidence was moderate for almost all outcomes. Conclusions The placebo effect of knee injections is significant, with functional improvements lasting even longer than those reported for pain perception. The high, long-lasting, and heterogeneous effects on the scales commonly used in clinical trials further highlight that the impact of placebo should not be overlooked in the research on and management of knee osteoarthritis.

The Impact of Immersive and Non-Immersive Virtual Reality Trends in Sensorimotor Recovery of Post-Stroke Patients-A Meta-Analysis

2021 ◽  
Vol 9 (5) ◽  
pp. 555-564
Author(s):  
Jaza Rizvi ◽  
◽  
Abid Khan ◽  
Sumaira Imran Farooqui ◽  
Bashir Ahmed Soomro ◽  
...  
Keyword(s):  
Virtual Reality ◽  
Randomized Controlled Trials ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Controlled Trials ◽  
Stroke Patients ◽  
Post Stroke ◽  
Randomized Controlled ◽  
Sensorimotor Recovery ◽  
The Impact

Virtual Reality (VR) is an approach in stroke rehabilitation with ever-improving technological advancement for targeted motor rehabilitation by providing a user interface in a simulated environment with proprioceptive and visual feedback. This meta-analysis intended to evaluate the impact of immersive and non-immersive VR-based interventions compared to conventional rehabilitation in sensorimotor recovery following stroke. Randomized Controlled Trials based on the impact of VR, either immersive or non-immersive type in comparison to conventional rehabilitation on post-stroke patients (>18 years) sensorimotor recovery were searched on six databases including Google Scholar, PEDro, MEDLINE, Cochrane Library, EMBASE, and Web of Science from August to November 2020. A total of 17 randomized controlled trials on VR based intervention showed significant improvement in sensorimotor recovery following a stroke in overall FMA outcomes in comparison to the control group with pool effects in terms of SMD in a random effect model showed an impact of 0.498 at 95% CI (p<0.001) depicts a moderate effect size. An immersive and non-immersive emerging VR trend appears to be a promising therapeutic tool in sensorimotor recovery following stroke.

scholarly journals Is Culture Expansion Necessary in Autologous Mesenchymal Stromal Cell Therapy to Obtain Superior Results in the Management of Knee Osteoarthritis?—Meta-Analysis of Randomized Controlled Trials

2021 ◽  
Vol 8 (12) ◽  
pp. 220
Author(s):  
Sathish Muthu ◽  
Randhi Rama Kartheek ◽  
Naveen Jeyaraman ◽  
Ramya Lakshmi Rajendran ◽  
Manish Khanna ◽  
...  
Keyword(s):  
Knee Osteoarthritis ◽  
Randomized Controlled Trials ◽  
Meta Analysis ◽  
Group Analysis ◽  
Cochrane Library ◽  
Osteoarthritis Of The Knee ◽  
Controlled Trials ◽  
Randomized Controlled ◽  
The Impact

Study Design: Meta-analysis. Objectives: We aimed to analyze the impact of cultured expansion of autologous mesenchymal stromal cells (MSCs) in the management of osteoarthritis of the knee from randomized controlled trials (RCTs) available in the literature. Materials and Methods: We conducted independent and duplicate electronic database searches including PubMed, Embase, Web of Science, and Cochrane Library until August 2021 for RCTs analyzing the efficacy and safety of culture-expanded compared to non-cultured autologous MSCs in the management of knee osteoarthritis. The Visual Analog Score (VAS) for pain, Western Ontario McMaster University’s Osteoarthritis Index (WOMAC), Lysholm score, Knee Osteoarthritis Outcome Score (KOOS), and adverse events were the analyzed outcomes. Analysis was performed in R-platform using OpenMeta [Analyst] software. Results: Overall, 17 studies involving 767 patients were included for analysis. None of the studies made a direct comparison of the culture expanded and non-cultured MSCs, hence we pooled the results of all the included studies of non-cultured and cultured types of MSC sources and made a comparative analysis of the outcomes. At six months, culture expanded MSCs showed significantly better improvement (p < 0.001) in VAS outcome. Uncultured MSCs, on the other hand, demonstrated significant VAS improvement in the long term (12 months) in VAS (p < 0.001), WOMAC (p = 0.025), KOOS score (p = 0.016) where cultured-expanded MSCs failed to demonstrate a significant change. Culturing of MSCs did not significantly increase the complications noted (p = 0.485). On sub-group analysis, adipose-derived uncultured MSCs outperformed culture-expanded MSCs at both short term (six months) and long term (12 months) in functional outcome parameters such as WOMAC (p < 0.001, p = 0.025), Lysholm (p < 0.006), and KOOS (p < 0.003) scores, respectively, compared to their controls. Conclusions: We identified a void in literature evaluating the impact of culture expansion of MSCs for use in knee osteoarthritis. Our indirect analysis of literature showed that culture expansion of autologous MSCs is not a necessary factor to obtain superior results in the management of knee osteoarthritis. Moreover, while using uncultured autologous MSCs, we recommend MSCs of adipose origin to obtain superior functional outcomes. However, we urge future trials of sufficient quality to validate our findings to arrive at a consensus on the need for culture expansion of MSCs for use in cellular therapy of knee osteoarthritis.

scholarly journals Exploring the Efficacy of Using Hypertonic Saline for Nebulizing Treatment in Children with Bronchiolitis: a Meta-Analysis of Randomized Controlled Trials

2020 ◽  
Author(s):  
Chia-Wen Hsieh ◽  
Hui-Chuan Su ◽  
Kee-Hsin Chen ◽  
Chiehfeng Chen
Keyword(s):  
Respiratory Distress ◽  
Hospital Stay ◽  
Randomized Controlled Trials ◽  
Hypertonic Saline ◽  
Saline Solution ◽  
Meta Analysis ◽  
Length Of Hospital Stay ◽  
Controlled Trials ◽  
Acute Bronchiolitis ◽  
Randomized Controlled

Abstract Introduction: Acute bronchiolitis is the most common lower respiratory infection in children. It is particularly prone to dyspnea among children under two years old. Inhaled hypertonic saline (HS) has recently been shown to be a favorable therapy, because of its facility to draw fluid from the submucosa and adventitial spaces, decreasing airway edema. The aim of this systematic review and meta-analysis was to evaluate the efficacy and safety of HS in the implementation of vapor treatment among children with bronchiolitis.Methods: A systematic literature search was conducted using Cochrane Library, PubMed, EMBASE and Airiti Library (Chinese Database) for randomized controlled trials from inception to July 2019. We calculated pooled risk ratios (RR), mean difference (MD) and 95% CI using RevMan 5.3 for meta-analysis.Results: In total, 4186 children from 32 publications were included. Compared to the control group, the HS group exhibited significantly reducing the level of severity of respiratory distress, included studies used the Clinical Severity Score (95% CI −1.15, −0.27, I² = 73%) and Respiratory Distress Assessment Instrument (95% CI −0.95, −0.26, I²= 0%) for evaluation respectively. Further, the HS group decreased the length of hospital stay 0.54 days (95% CI −0.86, −0.32, I²= 81%). Conclusion: We conclude that nebulized with 3% saline solution is effective in decreasing the length of hospital stay and the severity of symptoms as compared with 0.9% saline solution among children with acute bronchiolitis. Further rigor randomize controlled trails with large sample size are needed.

scholarly journals Hydroxychloroquine plus standard of care compared with standard of care alone in COVID-19: a meta-analysis of randomized controlled trials

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Bahman Amani ◽  
Ahmad Khanijahani ◽  
Behnam Amani
Keyword(s):  
Adverse Events ◽  
Randomized Controlled Trials ◽  
Meta Analysis ◽  
Length Of Hospital Stay ◽  
Standard Of Care ◽  
Cochrane Library ◽  
Controlled Trials ◽  
Efficacy And Safety ◽  
Randomized Controlled ◽  
Significant Difference

AbstractThe efficacy and safety of Hydroxychloroquine (HCQ) in treating coronavirus disease (COVID-19) is disputed. This systematic review and meta-analysis aimed to examine the efficacy and safety of HCQ in addition to standard of care (SOC) in COVID-19. PubMed, the Cochrane Library, Embase, Web of sciences, and medRxiv were searched up to March 15, 2021. Clinical studies registry databases were also searched for identifying potential clinical trials. The references list of the key studies was reviewed to identify additional relevant resources. The quality of the included studies was evaluated using the Cochrane Collaboration tool and Jadad checklist. Meta-analysis was performed using RevMan software (version 5.3). Eleven randomized controlled trials with a total number of 8161 patients were identified as eligible for meta-analysis. No significant differences were observed between the two treatment groups in terms of negative rate of polymerase chain reaction (PCR) (Risk ratio [RR]: 0.99, 95% confidence interval (CI) 0.90, 1.08; P = 0.76), PCR negative conversion time (Mean difference [MD]: − 1.06, 95% CI − 3.10, 0.97; P = 0.30), all-cause mortality (RR: 1.09, 95% CI 1.00, 1.20; P = 0.06), body temperature recovery time (MD: − 0.64, 95% CI − 1.37, 0.10; P = 0.09), length of hospital stay (MD: − 0.17, 95% CI − 0.80, 0.46; P = 0.59), use of mechanical ventilation (RR: 1.12, 95% CI 0.95, 1.32; P = 0.19), and disease progression (RR = 0.82, 95% CI 0.37, 1.85; P = 0.64). However, there was a significant difference between two groups regarding adverse events (RR: 1.81, 95% CI 1.36, 2.42; P < 0.05). The findings suggest that the addition of HCQ to SOC has no benefit in the treatment of hospitalized patients with COVID-19. Additionally, it is associated with more adverse events.

scholarly journals Intradiskal Injection of Methylene Blue for Discogenic Back Pain: A Meta-Analysis of Randomized Controlled Trials

2021 ◽  
Vol 82 (02) ◽  
pp. 161-165
Author(s):  
Ming Deng ◽  
Hui Huang ◽  
Yong-gang Ma ◽  
Yan Zhou ◽  
Qing Chen ◽  
...  
Keyword(s):  
Methylene Blue ◽  
Back Pain ◽  
Randomized Controlled Trials ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Control Group ◽  
Controlled Trials ◽  
Randomized Controlled ◽  
Pain Scores ◽  
The Impact

Abstract Introduction Intradiskal injection of methylene blue has some potential in alleviating discogenic back pain. This meta-analysis aims to explore the impact of intradiskal injection of methylene blue for discogenic back pain. Methods Several databases such as PubMed, EMbase, Web of Science, EBSCO, and Cochrane Library databases have been searched through November 2019, and randomized controlled trials (RCTs) assessing the effect of intradiskal injection of methylene blue for discogenic back pain are included. Results Three RCTs are included in the meta-analysis. Overall, compared with control group for discogenic back pain, intradiskal injection of methylene blue remarkably decreased pain scores at 3 months (mean difference [MD] = –0.71; 95% confidence interval [CI] = –0.96 to –0.46; p < 0.00001) and 6 months (MD = –13.92; 95% CI = –22.31 to –5.54; p = 001) and Oswestry Disability Index (ODI) at 4 to 6 weeks (MD = –10.39; 95% CI = –16.95 to –3.83; p = 0.002) and 3 months (MD = –3.66; 95% CI = –4.85 to –2.48; p < 0.00001), but demonstrated no obvious effect on ODI at 6 months (MD = –11.76; 95% CI = –33.33 to 9.80; p = 0.28). Conclusions Intradiskal injection of methylene blue can substantially decrease pain scores and improve function for discogenic back pain.

scholarly journals Is Fluoxetine Good for Subacute Stroke? A Meta-Analysis Evidenced From Randomized Controlled Trials

2021 ◽  
Vol 12 ◽  
Author(s):  
Guangjie Liu ◽  
Xingyu Yang ◽  
Tao Xue ◽  
Shujun Chen ◽  
Xin Wu ◽  
...  
Keyword(s):  
Randomized Controlled Trials ◽  
Fixed Effects ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Controlled Trials ◽  
Efficacy And Safety ◽  
Compulsive Disorder ◽  
Post Stroke ◽  
Randomized Controlled ◽  
Subacute Stroke

Background and Purpose: Fluoxetine is a drug commonly used to treat mental disorders, such as depression and obsessive–compulsive disorder, and some studies have shown that fluoxetine can improve motor and function recovery after stroke. Therefore, we performed a meta-analysis to investigate the efficacy and safety of fluoxetine in the treatment of post-stroke neurological recovery.Methods: PubMed, Embase, and Cochrane Library were searched for randomized controlled trials (RCTs) that were performed to assess the efficacy and safety of fluoxetine for functional and motor recovery in subacute stroke patients up to October 2020. Review Manager 5.3 software was used to assess the data. The risk ratio (RR) and standardized mean difference (SMD) were analyzed and calculated with a fixed effects model.Results: We pooled 6,788 patients from nine RCTs. The primary endpoint was modified Rankin Scale (mRS). Fluoxetine did not change the proportion of mRS ≤ 2 (P = 0.47). The secondary endpoints were Fugl-Meyer Motor Scale (FMMS), Barthel Index (BI), and National Institutes of Health Stroke Scale (NIHSS). Fluoxetine improved the FMMS (P &lt; 0.00001) and BI(P &lt; 0.0001) and showed a tendency of improving NIHSS (P = 0.08). In addition, we found that fluoxetine reduced the rate of new-onset depression (P &lt; 0.0001) and new antidepressants (P &lt; 0.0001).Conclusion: In post-stroke treatment, fluoxetine did not improve participants' mRS and NIHSS but improved FMMS and BI. This difference could result from heterogeneities between the trials: different treatment duration, clinical scales sensitivity, patient age, delay of inclusion, and severity of the deficit.

scholarly journals Primary versus delayed primary skin closure for prevention of surgical site infections in contaminated abdominal surgery: A meta-analysis of randomized controlled trials.

2021 ◽  
Author(s):  
Almegdad Sharafaldin Mohamed Ahmed ◽  
Ali mohammed ali mohammed ahmed ◽  
Basil Abubakr Yagoub Ibrahim ◽  
Mohammed.a.adam ◽  
Ali Yasen Y. Mohamedahmed ◽  
...  
Keyword(s):  
Hospital Stay ◽  
Randomized Controlled Trials ◽  
Meta Analysis ◽  
Length Of Hospital Stay ◽  
Surgical Site Infections ◽  
Risk Of Bias ◽  
Controlled Trials ◽  
Skin Closure ◽  
Randomized Controlled ◽  
Significant Difference

Abstract Background and purpose of the study: Surgical site infections (SSIs) are one of the most common hospital acquired infections. Delayed primary skin closure (DPC) is a technique that can be used when there is a contaminated or dirty wound. The purpose of this study was to evaluate the effectiveness of DPC in reducing SSIs in dirty and contaminated abdominal surgeries compared to primary skin closure (PC).Methods: An electronic search was conducted using six databases and clinical trials registers, only randomized controlled trials (RCTs) were included. selection of the included studies and data extraction were conducted by more than one reviewer independently. All of the included studies were assessed for the risk of bias. Pooling of the data was performed for surgical site infections as a primary outcome, and the length of hospital stay.Main findings:12 RCTs were included in the final analysis, including 1456 patients that were randomized to receive either PC or DPC. Complicated appendicitis was the most common type of wounds with a percentage of (82.8%). Pooling of the data showed a significant difference between the two methods, and DPC was found effective in reducing the risk for SSI with a risk ratio of 0.56([95% CI:0.44, 0.72], P < 0.001). The length of hospital stay was slightly lower in the PC group with a mean difference of 0.25(95% CI:0.02, 0.48) days from DPC group.Conclusions: DPC might be more effective than PC in reducing the risk of SSIs, however most of the studies included in this meta-analysis conveyed a high risk of bias, hence more well-designed RCTs are recommended in this area.

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