Surgical wound complications, particularly surgical site infection (SSI), remain common despite advances in perioperative care, and modern dressings—including emerging smart systems—are intended to optimize moisture balance, reduce bioburden, and support monitoring of healing. This narrative review, informed by PRISMA 2020, synthesized comparative clinical evidence on postoperative dressings across surgical specialties. PubMed and Embase were searched for peer-reviewed comparative human studies published in 2015–2025 involving adults undergoing surgery with primary closure or secondary intention healing. Outcomes included SSI, time to epithelialization/closure, scar outcomes, pain, peri-wound skin integrity, and dressing change frequency. Nine studies met the inclusion criteria across orthopedics, general and endocrine surgery, otolaryngology, maxillofacial surgery, and surgical oncology. In hip/knee arthroplasty, hydrofiber dressings were associated with lower SSI rates versus standard/absorbent dressings. A meta-analysis suggested that moist and silver-based dressings generally outperformed gauze, with ionic silver ranking highest for healing and metallic silver for SSI prevention, and hydrocolloids reduced dressing change frequency. Oxygen diffusion therapy improved scar outcomes after cervicotomy, and chitosan gel reduced synechiae after endoscopic sinus surgery. Evidence in oncologic surgery was inconclusive, and heterogeneity in interventions, endpoints, and follow-up limited pooling. Overall, advanced postoperative dressings may improve selected outcomes compared with traditional gauze, but effects appear procedure- and context-dependent; future studies should standardize outcomes, extend follow-up, and incorporate cost-effectiveness and patient-reported measures, alongside evaluation of sensor-enabled smart dressings.
Joniec et al. (Fri,) studied this question.