与胃肠道手术中标准敷料相比,先进敷料在预防手术部位感染方面的有效性:日本外科感染学会指南修订的系统回顾和荟萃分析

IF 2.9 4区 医学 Q2 GASTROENTEROLOGY & HEPATOLOGY
Keita Kouzu, Hironori Tsujimoto, Seiichi Shinji, Hiroji Shinkawa, Koji Tamura, Yukio Sato, Koji Munakata, Yasunari Fukuda, Daisuke Koike, Hiromu Miyake, Yohei Hosoda, Motoi Uchino, Hiroki Ohge, Junzo Shimizu, Seiji Haji, Yasuhiko Mohri, Chizuru Yamashita, Yuichi Kitagawa, Motomu Kobayashi, Yuki Hanai, Hiroshi Nobuhara, Masahiro Yoshida, Toru Mizuguchi, Toshihiko Mayumi, Yuko Kitagawa
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引用次数: 0

摘要

作为日本外科感染学会(JSSI) SSI预防指南更新的一部分,这是一项系统综述和荟萃分析,研究了使用先进敷料专门用于预防胃肠道手术手术部位感染(SSI)的伤口覆盖效果。方法于2024年7月检索CENTRAL、PubMed和ICHUSHI-Web,纳入比较胃肠道外科伤口高级敷料和标准敷料的随机对照试验(rct)。CRD42024569084)。三位作者独立筛选了随机对照试验。我们对提取数据的证据体的偏倚风险和确定性进行了评估。主要结局是浅表SSI,次要结局是术后住院时间、费用和过敏。本研究得到了JSSI的部分支持。结果共纳入7项rct, 927例患者。与使用标准敷料相比,使用高级敷料显著降低了SSI的风险(风险比:0.54,95%可信区间:0.34-0.88)。证据的确定性被评为中等。根据亚组分析,先进的敷料降低了结直肠手术中SSI的风险。与标准敷料相比,高级敷料并没有减少术后住院时间或费用。只有一名患者使用银浸渍敷料报告过敏。结论采用高级敷料处理胃肠外科原发创面与使用标准敷料相比,发生SSI的风险明显降低。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Effectiveness of advanced dressings in preventing surgical site infections compared to that of standard dressings in gastrointestinal surgery: A systematic review and meta-analysis for guideline revision by the Japanese Society for Surgical Infection

Introduction

This is a systematic review and meta-analysis of the efficacy of wound coverage using advanced dressings specifically for the prevention of surgical site infections (SSI) in gastrointestinal surgery, as part of the update of the SSI prevention guidelines of the Japan Society for Surgical Infection (JSSI).

Methods

After searching CENTRAL, PubMed, and ICHUSHI-Web in July 2024, we included randomized controlled trials (RCTs) comparing advanced dressings and standard dressings for surgical wounds in gastrointestinal surgery (PROSPERO No. CRD42024569084). Three authors independently screened the RCTs. We assessed the risk of bias and certainty of the body of evidence for the extracted data. The primary outcome was superficial SSI, and the secondary outcomes were length of postoperative hospital stay, costs, and allergy. This study was partially supported by the JSSI.

Results

A total of seven RCTs and 927 patients were included. The use of advanced dressings significantly lowered the risk of SSI compared to that associated with standard dressings (risk ratio: 0.54, 95% confidence intervals: 0.34–0.88). The certainty of the evidence was rated as moderate. According to the subgroup analysis, advanced dressings reduced the risk of SSI in colorectal surgery. Advanced dressings did not reduce the length of postoperative hospital stay or costs compared to that of standard dressings. Allergies were reported in only one patient using silver-impregnated dressings.

Conclusion

The use of advanced dressings for primary wounds in gastrointestinal surgery was associated with a significantly lower risk of SSI than that associated with standard dressings.

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来源期刊
Annals of Gastroenterological Surgery
Annals of Gastroenterological Surgery GASTROENTEROLOGY & HEPATOLOGY-
CiteScore
5.30
自引率
11.10%
发文量
98
审稿时长
11 weeks
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