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一项关于伤口边缘保护装置在降低腹部手术患者手术部位感染方面临床效果的系统评价。

A systematic review of clinical effectiveness of wound edge protector devices in reducing surgical site infections in patients undergoing abdominal surgery.

作者信息

Sajid Muhammad Shafique, Rathore M A, Sains P, Singh K K

机构信息

Department of General, Endoscopic and Laparoscopic Colorectal Surgery, Brighton and Sussex University Hospitals NHS Trust, Eastern Road, Brighton, BN2 5BE, UK.

Department of General, Endoscopic and Laparoscopic Colorectal Surgery, Pilgrims Hospital, United Lincolnshire Hospitals NHS Trust, Sibsey Road, Boston, Lincolnshire, PE21 9QS, UK.

出版信息

Updates Surg. 2017 Mar;69(1):21-28. doi: 10.1007/s13304-017-0415-2. Epub 2017 Jan 25.

Abstract

This article highlights the clinical effectiveness of wound edge protector devices (WEPD) in preventing the post-operative surgical site infections (SSI) in patients undergoing abdominal surgery. Using the principles of meta-analysis and systematic review as recommended by the Cochrane Collaboration, the data from selected randomized, controlled trials (RCTs) were analysed to generate summated outcome and presented in the form of odds ratio (OR). Eighteen RCTs on 3808 reported the effectiveness of WEPD in patients undergoing abdominal surgery. The use of WEPD was associated with the reduced incidence of overall SSI (OR 0.59; 95% CI 0.43-0.81; z = 3.30; p < 0.001) and superficial SSI (OR 0.42; 95% CI 0.18-0.95; z = 2.09; p < 0.04). In addition, WEPD also successfully reduced the risk of SSI in clean-contaminated wounds (OR 0.67; 95% CI 0.46-0.98; z = 2.06; p < 0.04) as well as in contaminated wounds (OR 0.24; 95% CI 0.12-0.49; z = 3.96; p < 0.0001). WEPD seems to be an effective intervention to reduce the risk of post-operative SSI in patients undergoing abdominal surgery.

摘要

本文重点介绍了伤口边缘保护装置(WEPD)在预防腹部手术患者术后手术部位感染(SSI)方面的临床效果。按照Cochrane协作网推荐的荟萃分析和系统评价原则,对所选随机对照试验(RCT)的数据进行分析,以得出汇总结果,并以比值比(OR)的形式呈现。18项涉及3808例患者的RCT报告了WEPD在腹部手术患者中的有效性。使用WEPD与总体SSI发生率降低相关(OR 0.59;95%CI 0.43 - 0.81;z = 3.30;p < 0.001)以及浅表SSI发生率降低相关(OR 0.42;95%CI 0.18 - 0.95;z = 2.09;p < 0.04)。此外,WEPD还成功降低了清洁 - 污染伤口(OR 0.67;95%CI 0.46 - 0.98;z = 2.06;p < 0.04)以及污染伤口(OR 0.24;95%CI 0.12 - 0.49;z = 3.96;p < 0.0001)发生SSI的风险。WEPD似乎是一种有效的干预措施,可降低腹部手术患者术后发生SSI的风险。

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