Shogan BD, Vogel JD, Davis BR, et al. The American Society of Colon and Rectal Surgeons Clinical Practice Guidelines for Preventing Surgical Site Infection. <em>Dis Colon Rectum</em>. 2024;67(11):1368-1382. doi:10.1097/DCR.0000000000003450

"Wound protectors can decrease the incidence of SSI after colorectal surgery. Strength of recommendation: strong based on high-quality evidence."

"...double-ring devices were found to exhibit a greater protective effect than single-ring devices."

Annals of Surgery; 2018 July

Bressan AK, Aubin JM, Martel G, et al. Efficacy of a Dual-ring Wound Protector for Prevention of Surgical Site Infections After Pancreaticoduodenectomy in Patients With Intrabiliary Stents: A Randomized Clinical Trial. <em>Ann Surg.</em> 2018;268(1):35-40. doi:10.1097/SLA.0000000000002614

“Among adult patients with intrabiliary stents, the use of a dual-ring wound protector during [pancreaticoduodenectomy] significantly reduces the risk of incisional SSI (surgical site infection).”

Surgical Endoscopy; 2018 March

Zhang L, Elsolh B, Patel SV. Wound protectors in reducing surgical site infections in lower gastrointestinal surgery: an updated meta-analysis. <em>Surg Endosc.</em> 2018;32(3):1111-1122. doi:10.1007/s00464-017-6012-0

“We demonstrated evidence of a subgroup difference where dual-ring wound protectors reduced SSIs while single-ring retractors did not, which provides greater insight in the choice of wound protection devices.

“Our meta-analysis found that dual-ring wound protectors reduce the odds of SSI (surgical site infection) in patients undergoing lower gastrointestinal surgery. . . .”

Annals of Surgery; 2012 July

Edwards JP, Ho AL, Tee MC, Dixon E, Ball CG. Wound protectors reduce surgical site infection: a meta-analysis of randomized controlled trials. <em>Ann Surg.</em> 2012;256(1):53-59. doi:10.1097/SLA.0b013e3182570372

“Our study suggests that the use of wound protectors decreases the risk of SSI by 45%. Our number needed to treat suggests that only 10 patients would have to be treated intraoperatively with a wound protector to prevent 1 SSI. . . .

“Impervious plastic wound protectors reduce the risk of SSI (surgical site infection) when employed in non-trauma-related gastrointestinal and biliary tract surgery. Wound protectors represent a safe and simple intervention that may reduce postoperative morbidity and mortality. . . .”

Colorectal Disease; 2012 June

Cheng KP, Roslani AC, Sehha N, et al. ALEXIS O-Ring wound retractor vs conventional wound protection for the prevention of surgical site infections in colorectal resections(1). <em>Colorectal Dis.</em> 2012;14(6):e346-e351. doi:10.1111/j.1463-1318.2012.02943.x

“The [Alexis] wound retractor is more effective in preventing SSI (surgical site infection) in elective colorectal resections compared with conventional methods.”

Diseases of the Colon & Rectum; 2010 October

Reid K, Pockney P, Draganic B, Smith SR. Barrier wound protection decreases surgical site infection in open elective colorectal surgery: a randomized clinical trial. <em>Dis Colon Rectum.</em> 2010;53(10):1374-1380. doi:10.1007/DCR.0b013e3181ed3f7e

“In this study the use of barrier wound protection in elective open colorectal resectional surgery resulted in a clinically significant reduction in incisional surgical site infections. Barrier wound protection of this nature should be considered routine in this type of surgery.”

Archives of Surgery; 2009 September

Lee P, Waxman K, Taylor B, Yim S. Use of Wound-Protection System and Postoperative Wound-Infection Rates in Open Appendectomy: A Randomized Prospective Trial. <em>Arch Surg.</em> 2009;144(9):872–875. doi:10.1001/archsurg.2009.151

“Our data support the use of a wound-protection device in open surgery as a method of decreasing postoperative wound-infection rates. This technique could be applied to a broader spectrum of open surgical procedures and ultimately reduce the economic and emotional burden of a preventable SSI (surgical site infection).”

The Journal of Trauma-Injury & Critical Care; 2007 January

Horiuchi T, Tanishima H, Tamagawa K, et al. Randomized, controlled investigation of the anti-infective properties of the Alexis retractor/protector of incision sites. <em>J Trauma.</em> 2007;62(1):212-215. doi:10.1097/01.ta.0000196704.78785.ae

“The results of this study demonstrate that wound infection decreased significantly in the with Alexis retractor group.”