Department of Infectious Diseases, Singapore General Hospital, Singapore.
Am J Infect Control. 2013 Feb;41(2):167-73. doi: 10.1016/j.ajic.2012.02.014. Epub 2012 Jun 19.
Chlorhexidine showering is frequently recommended as an important preoperative measure to prevent surgical site infection (SSI). However, the efficacy of this approach is uncertain.
A search of electronic databases was undertaken to identify prospective controlled trials evaluating whole-body preoperative bathing with chlorhexidine versus placebo or no bath for prevention of SSI. Summary risk ratios were calculated using a DerSimonian-Laird random effects model and a Mantel-Haenzel dichotomous effects model.
Sixteen trials met inclusion criteria with a total of 17,932 patients: 7,952 patients received a chlorhexidine bath, and 9,980 patients were allocated to various comparator groups. Overall, 6.8% of patients developed SSI in the chlorhexidine group compared with 7.2% of patients in the comparator groups. Chlorhexidine bathing did not significantly reduce overall incidence of SSI when compared with soap, placebo, or no shower or bath (relative risk, 0.90; 95% confidence interval: 0.77-1.05, P = .19).
Meta-analysis of available clinical trials suggests no appreciable benefit of preoperative whole-body chlorhexidine bathing for prevention of SSI. However, most studies omitted details of chlorhexidine application. Better designed trials with a specified duration and frequency of exposure to chlorhexidine are needed to determine whether preoperative whole-body chlorhexidine bathing reduces SSI.
氯己定沐浴常被推荐作为预防手术部位感染（SSI）的重要术前措施。然而，这种方法的疗效尚不确定。
对电子数据库进行了检索，以确定评估全身术前氯己定沐浴与安慰剂或不沐浴预防 SSI 的前瞻性对照试验。使用 DerSimonian-Laird 随机效应模型和 Mantel-Haenzel 二项式效应模型计算汇总风险比。
共有 16 项试验符合纳入标准，共纳入 17932 例患者：7952 例患者接受氯己定沐浴，9980 例患者分配至各种对照组。总体而言，氯己定组有 6.8%的患者发生 SSI，而对照组有 7.2%的患者发生 SSI。与肥皂、安慰剂或不沐浴相比，氯己定沐浴并未显著降低 SSI 的总体发生率（相对风险，0.90；95%置信区间：0.77-1.05，P =.19）。
对现有临床试验的荟萃分析表明，术前全身氯己定沐浴对预防 SSI 没有明显益处。然而，大多数研究都省略了氯己定应用的细节。需要设计更好的试验，规定氯己定暴露的持续时间和频率，以确定术前全身氯己定沐浴是否可降低 SSI。
