A network meta-analysis of the timing of wound dressing removal.

IF 1.1 4区医学 Q3 SURGERY

Annals of the Royal College of Surgeons of England Pub Date : 2024-07-31 DOI:10.1308/rcsann.2023.0083

Rjks Hwang, D L Crook, C S Allan, S Sarkar

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引用次数: 0

Abstract

Introduction: Wounds are invariably dressed postoperatively but the evidence for the timing of dressing changes is limited. This meta-analysis evaluated whether the relative risk of wound infection varies depending on when dressings are changed.

Methods: A frequentist random-effects network meta-analysis was conducted on the results of a systematic review of the MEDLINE^®, Ovid^®, Scopus^®, Web of Science™ and PubMed^® databases and the Cochrane Central Register of Controlled Trials performed in May 2023. Evidence quality was graded using the Confidence In Network Meta-Analysis tool.

Results: A total of 4 studies were included with 878 patients. A significant increase in the relative risk of wound infection was found when dressings were left in situ for more than 4.5 days when compared with 48 hours (3.18, 95% confidence interval: 1.22-8.33). There were no significant differences in the relative risk of infection between the other groups. Model heterogeneity and inconsistency were insignificant (Cochran's Q: 0.44, p=0.51). The quality of the evidence was graded as generally very low and risk of bias evaluations showed it to be of high concern for bias.

Conclusions: Late dressing changes significantly increase the risks of wound infection and changes at 48 hours minimise these risks. There was no advantage demonstrated for earlier dressing changes. Ensuring that dressings are changed appropriately can minimise patient harm and health service costs.

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关于伤口敷料去除时机的网络荟萃分析。

简介：术后伤口一定要包扎，但关于更换敷料时间的证据却很有限。这项荟萃分析评估了伤口感染的相对风险是否会因更换敷料的时间不同而变化：方法：对 2023 年 5 月进行的 MEDLINE®、Ovid®、Scopus®、Web of Science™ 和 PubMed® 数据库以及 Cochrane 对照试验中央登记册的系统性综述结果进行了频数随机效应网络荟萃分析。证据质量采用信心网络元分析工具进行分级：结果：共纳入 4 项研究，878 名患者。与 48 小时相比，敷料放置超过 4.5 天的伤口感染相对风险明显增加（3.18，95% 置信区间：1.22-8.33）。其他组别的感染相对风险没有明显差异。模型异质性和不一致性不显著（Cochran's Q：0.44，P=0.51）。证据质量一般被评为很低，偏倚风险评估显示其偏倚风险很高：结论：延迟更换敷料会大大增加伤口感染的风险，而在 48 小时内更换敷料可将这些风险降至最低。提前换药没有优势。确保适当更换敷料可以最大限度地减少对患者的伤害和医疗服务成本。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Annals of the Royal College of Surgeons of England Medicine-Surgery

CiteScore

2.40

自引率

0.00%

发文量

316

期刊介绍： The Annals of The Royal College of Surgeons of England is the official scholarly research journal of the Royal College of Surgeons and is published eight times a year in January, February, March, April, May, July, September and November. The main aim of the journal is to publish high-quality, peer-reviewed papers that relate to all branches of surgery. The Annals also includes letters and comments, a regular technical section, controversial topics, CORESS feedback and book reviews. The editorial board is composed of experts from all the surgical specialties.