腹股沟疝修补术使用预防性抗生素的荟萃分析。
Prophylactic antibiotics for mesh inguinal hernioplasty: a meta-analysis.
作者信息
Sanabria Alvaro, Domínguez Luis Carlos, Valdivieso Eduardo, Gómez Gabriel
机构信息
Grupo Colaborativo de Epidemiología Quirúrgica, Department of Surgery, School of Medicine, Pontificia Universidad Javeriana-Hospital, Universitario San Ignacio, Bogotá, Colombia.
出版信息
Ann Surg. 2007 Mar;245(3):392-6. doi: 10.1097/01.sla.0000250412.08210.8e.
OBJECTIVE
To assess the effectiveness of antibiotic prophylaxis in mesh hernioplasty.
BACKGROUND
Antibiotic prophylaxis use in mesh inguinal hernioplasty is controversial. Available evidence is nonconclusive because of the low number of clinical trials assessing its effectiveness. Some trials have a small sample size that could overestimate or underestimate the real effectiveness of this intervention. Meta-analysis is a good method to improve these methodological flaws.
METHODS
Meta-analysis intended to measure the benefits of antibiotic prophylaxis on surgical site infection rate in adult patients scheduled for mesh inguinal hernioplasty. Six randomized clinical trials were found. Quality was assessed using Cochrane Collaboration criteria.
RESULTS
A total of 2507 patients were analyzed. Surgical site infection frequency was 1.38% in the antibiotic group versus 2.89% in the control group (odds ratio = 0.48; 95% confidence interval, 0.27-0.85). There was no statistical heterogeneity. Sensitivity analysis by quality did not show differences in overall results.
CONCLUSION
Antibiotic prophylaxis use in patients submitted to mesh inguinal hernioplasty decreased the rate of surgical site infection by almost 50%.
目的
评估抗生素预防在补片疝修补术中的有效性。
背景
抗生素预防在补片腹股沟疝修补术中的应用存在争议。由于评估其有效性的临床试验数量较少，现有证据尚无定论。一些试验样本量小，可能高估或低估了这种干预措施的实际有效性。荟萃分析是改善这些方法学缺陷的好方法。
方法
荟萃分析旨在衡量抗生素预防对计划进行补片腹股沟疝修补术的成年患者手术部位感染率的益处。共找到六项随机临床试验。使用Cochrane协作标准评估质量。
结果
共分析了2507例患者。抗生素组手术部位感染发生率为1.38%，而对照组为2.89%（优势比=0.48；95%置信区间，0.27-0.85）。无统计学异质性。按质量进行的敏感性分析未显示总体结果存在差异。
结论
接受补片腹股沟疝修补术的患者使用抗生素预防可使手术部位感染率降低近50%。
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