Zapata-Copete James, Aguilera-Mosquera Santiago, García-Perdomo Herney Andrés
Epidemiology Department, Universidad Libre, Cali, Colombia; UROGIV Research Group at Universidad del Valle, Cali, Colombia.
Plastic Surgery Department at Universidad del Valle, Cali, Colombia.
J Plast Reconstr Aesthet Surg. 2017 Dec;70(12):1689-1695. doi: 10.1016/j.bjps.2017.08.005. Epub 2017 Aug 16.
To determine the effectiveness and harm of using antibiotic prophylaxis versus placebo or no intervention in patients undergoing breast reduction surgery to prevent surgical site infection.
A search strategy was conducted in the MEDLINE, CENTRAL, EMBASE, and LILACS databases. Searches were also conducted in other databases and unpublished literature. Clinical trials were included without language restrictions. The risk of bias was evaluated with the Cochrane Collaboration's tool. An analysis of fixed effects was conducted. The primary outcome was surgical site infection. The secondary outcomes were delayed wound healing and adverse effects. The measure of the effect was the risk difference (RD) with a 95% confidence interval (CI). The planned interventions were antibiotic prophylaxis versus placebo/no intervention.
Five articles were included in the qualitative and quantitative analysis. A total of 584 patients were included from the five studies. A low risk of bias was shown for most of the study items. The overall RD for surgical site infection was -0.08 (95% CI -0.14--0.03), favoring antibiotic prophylaxis compared with placebo.
Antibiotic prophylaxis lowers the incidence of surgical site infection in breast reduction surgery compared with placebo or no intervention.
确定在接受乳房缩小手术的患者中使用抗生素预防与安慰剂或不进行干预相比,预防手术部位感染的有效性和危害。
在MEDLINE、CENTRAL、EMBASE和LILACS数据库中进行检索策略。还在其他数据库和未发表的文献中进行了检索。纳入无语言限制的临床试验。使用Cochrane协作工具评估偏倚风险。进行固定效应分析。主要结局是手术部位感染。次要结局是伤口愈合延迟和不良反应。效应量的衡量指标是风险差(RD)及其95%置信区间(CI)。计划的干预措施是抗生素预防与安慰剂/不干预。
定性和定量分析纳入了5篇文章。五项研究共纳入584例患者。大多数研究项目显示偏倚风险较低。手术部位感染的总体RD为-0.08(95%CI -0.14--0.03),与安慰剂相比,抗生素预防更具优势。
与安慰剂或不进行干预相比,抗生素预防可降低乳房缩小手术中手术部位感染的发生率。