A Cochrane review [Abstract] 1 included 35 studies. Of these, 23 were trials of prophylactic systemic antibiotics, 3 of rifampicin-bonded grafts, 3 of preoperative skin antisepsis, 2 of suction wound drainage, 2 of minimally invasive in situ bypass techniques, and individual trials of intraoperative glove change and wound closure techniques. Prophylactic systemic antibiotics reduced the risk of wound infection (RR 0.25, 95% CI 0.17 to 0.38; 10 studies, n=1 297) and early graft infection (RR 0.31, 95% CI 0.11 to 0.85; 7 studies, n=1 184) compared to placebo. Antibiotic prophylaxis for greater than 24 hours appears to be of no added benefit (RR 1.28, 95% CI 0.82 to 1.98; 3 studies, n=531). There was no evidence that prophylactic rifampicin bonding to dacron grafts reduced graft infection at either one month (RR 0.63, 95% CI 0.27 to 1.49; 3 studies, n=3 379) or two years (RR 1.05, 95% CI 0.46 to 2.40; 2 studies, n=857). There was no evidence of a beneficial or detrimental effect on rates of wound infection with suction groin-wound drainage (RR 0.96 95% CI 0.50 to 1.86; 2 studies, n=227) or of any benefit from a preoperative bathing or shower regimen with antiseptic agents over unmedicated bathing (RR 0.97, 95% CI 0.70 to 1.36; 3 studies, n=342).
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