狗咬伤后感染预防和治疗:随机对照试验的系统回顾。

Journal of Trauma and Injury Pub Date : 2025-03-01 Epub Date: 2025-03-31 DOI:10.20408/jti.2024.0069
Yongsik Yoon, Dukho Kim, Dongwuk Lee, Hyeongyu Min, Junhyuk Choi
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引用次数: 0

摘要

目的:被狗咬伤是全球公共卫生面临的一项重大挑战,其后果从轻伤到死亡不等。尽管被狗咬伤的情况普遍存在,但人们对最有效的预防和治疗策略尚未达成共识。本系统综述旨在整合和评估研究预防和治疗狗咬伤干预措施有效性的随机对照试验(RCT):方法:在 CINAHL、Embase、MEDLINE、Web of Science 和 PubMed 数据库中对过去 10 年内发表的 RCT 进行了全面检索。只要研究的重点是预防或治疗被狗咬伤的干预措施,均被纳入研究范围。主要结果包括狗咬伤的感染率和恢复时间、干预措施在预防或降低咬伤严重程度方面的效果以及相关的健康结果。采用 Cochrane 协作工具对偏倚风险进行了评估:五项研究符合资格标准,共有 1,148 人参与。这些研究考察了各种干预措施,包括医疗技术(医用胶水、负压伤口疗法和高压氧疗法)、伤口管理策略(主要缝合与非缝合)和教育干预措施。对四项研究进行的荟萃分析表明,干预组与对照组的感染率无明显差异(风险比为 0.69;95% 置信区间 [CI],0.27-1.77;I2=62%;P=0.44)。不过,每项研究中的干预措施都缩短了康复时间(平均差异为 11.25 天;95% 置信区间为 8.44-14.07 天;I2=99%;P=0.44):尽管纳入的研究表明,某些干预措施对治疗狗咬伤有潜在益处,尤其是在缩短恢复时间方面,但有关预防感染的证据仍不明确。该领域高质量的研究性临床试验数量有限,这凸显了进一步研究的必要性,以便为狗咬伤的预防和治疗制定循证指南。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Infection prevention and treatment following dog bites: a systematic review of randomized controlled trials.

Purpose: Dog bites pose a significant global public health challenge, with outcomes that range from minor injuries to fatalities. Despite their prevalence, no consensus has been established regarding the most effective prevention and treatment strategies. This systematic review aimed to consolidate and evaluate randomized controlled trials (RCTs) examining the effectiveness of interventions in preventing and treating dog bites.

Methods: A comprehensive search was conducted across the CINAHL, Embase, MEDLINE, Web of Science, and PubMed databases for RCTs published within the last 10 years. Studies were included if they focused on interventions to prevent or treat dog bites. Primary outcomes included the infection rate and recovery time of dog bites, the effectiveness of interventions in preventing or reducing bite severity, and associated health outcomes. The risk of bias was assessed using the Cochrane Collaboration tool.

Results: Five RCTs met the eligibility criteria, with a total of 1,148 participants. These studies examined various interventions, including medical techniques (medical glue, negative pressure wound therapy, and hyperbaric oxygen therapy), wound management strategies (primary suturing versus non-suturing), and educational interventions. A meta-analysis of four studies revealed no significant difference in infection rates between the intervention and control groups (risk ratio, 0.69; 95% confidence interval [CI], 0.27-1.77; I2=62%; P=0.44). However, the interventions examined in each study demonstrated shorter recovery times (mean difference, 11.25 days; 95% CI, 8.44-14.07 days; I2=99%; P<0.001).

Conclusions: Although the included studies suggest potential benefits of certain interventions in treating dog bites, particularly in reducing recovery time, the evidence regarding infection prevention remains inconclusive. The limited number of high-quality RCTs in this field highlights the need for further research to establish evidence-based guidelines for dog bite prevention and treatment.

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