使用酒精进行皮肤准备与先使用酒精再使用任何防腐剂预防菌血症或输血时血液污染的比较。
Skin preparation with alcohol versus alcohol followed by any antiseptic for preventing bacteraemia or contamination of blood for transfusion.
作者信息
Webster Joan, Bell-Syer Sally E M, Foxlee Ruth
机构信息
Centre for Clinical Nursing, Royal Brisbane and Women's Hospital, Level 2, Building 34, Butterfield Street, Brisbane, Queensland, Australia, 4029.
出版信息
Cochrane Database Syst Rev. 2015 Feb 12;2015(2):CD007948. doi: 10.1002/14651858.CD007948.pub3.
BACKGROUND
Blood for transfusion may become contaminated at any point between collection and transfusion and may result in bacteraemia (the presence of bacteria in the blood), severe illness or even death for the blood recipient. Donor arm skin is one potential source of blood contamination, so it is usual to cleanse the skin with an antiseptic before blood donation. One-step and two-step alcohol based antiseptic regimens are both commonly advocated but there is uncertainty as to which is most effective.
OBJECTIVES
To assess the effects of cleansing the skin of blood donors with alcohol in a one-step compared with alcohol in a two-step procedure to prevent contamination of collected blood or bacteraemia in the recipient.
SEARCH METHODS
In December 2014, for this third update, we searched the Cochrane Wounds Group Specialised Register; The Cochrane Central Register of Controlled Trials (CENTRAL), The Cochrane Library; Ovid MEDLINE; Ovid MEDLINE (In-Process & Other Non-Indexed Citations); Ovid EMBASE; and EBSCO CINAHL.
SELECTION CRITERIA
All randomised trials (RCTs) comparing alcohol based donor skin cleansing in a one-step versus a two-step process that includes alcohol and any other antiseptic for pre-venepuncture skin cleansing were considered. Quasi randomised trials were to have been considered in the absence of RCTs.
DATA COLLECTION AND ANALYSIS
Two review authors independently assessed studies for inclusion.
MAIN RESULTS
No studies (RCTs or quasi RCTs) met the inclusion criteria.
AUTHORS' CONCLUSIONS: We did not identify any eligible studies for inclusion in this review. It is therefore unclear whether a two-step, alcohol followed by antiseptic skin cleansing process prior to blood donation confers any reduction in the risk of blood contamination or bacteraemia in blood recipients, or conversely whether a one-step process increases risk above that associated with a two-step process.
背景
用于输血的血液在采集和输血之间的任何环节都可能被污染，这可能导致受血者发生菌血症（血液中存在细菌）、重病甚至死亡。献血者手臂皮肤是血液污染的一个潜在来源，因此在献血前通常用消毒剂清洁皮肤。基于酒精的一步法和两步法消毒方案都普遍被提倡，但哪种方法最有效尚不确定。
目的
评估与两步法酒精消毒相比，一步法酒精清洁献血者皮肤以预防采集的血液被污染或受血者发生菌血症的效果。
检索方法
2014年12月，为进行本次第三次更新，我们检索了Cochrane伤口小组专业注册库；Cochrane对照试验中央注册库（CENTRAL）、Cochrane图书馆；Ovid MEDLINE；Ovid MEDLINE（在研及其他非索引引文）；Ovid EMBASE；以及EBSCO CINAHL。
选择标准
所有比较一步法与两步法基于酒精的献血者皮肤清洁的随机对照试验（RCT）均被纳入，两步法包括酒精以及任何其他用于静脉穿刺前皮肤清洁的消毒剂。若没有RCT，则考虑纳入半随机试验。
数据收集与分析
两位综述作者独立评估纳入研究。
主要结果
没有研究（RCT或半RCT）符合纳入标准。
作者结论
我们未识别出任何符合纳入本综述的合格研究。因此，尚不清楚献血前两步法（先酒精后消毒剂皮肤清洁）是否能降低受血者血液污染或菌血症的风险，反之，一步法是否会使风险高于两步法。
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