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肩部手术中减少感染的局部治疗:系统评价与荟萃分析方案

Topical Treatments in Reducing Infection in Shoulder Surgery: Protocol for a Systematic Review and Meta-analysis.

作者信息

Sewpaul Yash, Leung Brook, Hartland Alexander W, Nayar Sandeep Krishan, Rashid Mustafa S

机构信息

Lancaster Medical School, Lancaster University, LA1 4YW, GB.

Royal London Hospital, Whitechapel Rd, London, E1 1FR, UK.

出版信息

Int J Surg Protoc. 2022 Jun 9;26(1):35-40. doi: 10.29337/ijsp.174. eCollection 2022.

DOI:10.29337/ijsp.174
PMID:35794885
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9187290/
Abstract

INTRODUCTION

is a gram-positive anaerobe that is found on the dermis and epidermis of the shoulder and is the most commonly identifiable cause of periprosthetic shoulder joint infection. Various topical strategies have been investigated to reduce the prevalence of , with several demonstrating efficacy in reducing the positive culture. The aim of this systematic review and meta-analysis is to review the literature to assess the effectiveness of topical preparations in reducing the prevalence of in shoulder surgery.

METHODS

The study protocol was designed and registered prospectively on PROSPERO (International prospective register for systematic reviews). Databases used for the literature search will include MEDLINE, EMBASE, PsycINFO, and The Cochrane Library. Randomised controlled trials (RCTs) evaluating the use of any topical preparation against placebo, in all types of shoulder surgery, will be included. Our primary outcome is the number of colony forming units of P acnes. Secondary outcomes will include adverse events such as skin irritation, wound dehiscence, and the incidence of revision surgery due to infection. The Cochrane Risk of Bias Tool 2.0 and Jadad score will be used to assess the quality of methodology of the studies. Statistical analysis will be used to assess inconsistency and bias across included studies. Comparable outcome data will be pooled and analysed quantitatively or qualitatively as appropriate.

ETHICS AND DISSEMINATION

No ethical clearances required for this study. This systematic review and meta-analysis will be published in a peer-reviewed journal.

HIGHLIGHTS

Various topical strategies have been investigated to reduce the prevalence of P acnes, the most common identifiable cause of periprosthetic shoulder joint infection, with several demonstrating efficacy in reducing the positive culture.This systematic review and meta-analysis evaluates the effectiveness of topical preparations in reducing the prevalence of P acnes in shoulder surgery.Our primary outcome is the number of colony forming units of P acnes.

REGISTRATION

PROSPERO 2022 CRD42022310312.

摘要

引言

痤疮丙酸杆菌是一种革兰氏阳性厌氧菌,存在于肩部的真皮和表皮,是人工关节周围肩关节感染最常见的可识别病因。人们已经研究了各种局部治疗策略以降低痤疮丙酸杆菌的感染率,其中一些策略在减少阳性培养方面显示出疗效。本系统评价和荟萃分析的目的是回顾文献,以评估局部制剂在降低肩部手术中痤疮丙酸杆菌感染率方面的有效性。

方法

研究方案已在PROSPERO(国际系统评价前瞻性注册库)上进行了前瞻性设计和注册。用于文献检索的数据库将包括MEDLINE、EMBASE、PsycINFO和Cochrane图书馆。将纳入评估在所有类型的肩部手术中使用任何局部制剂与安慰剂相比的随机对照试验(RCT)。我们的主要结局是痤疮丙酸杆菌的菌落形成单位数量。次要结局将包括不良事件,如皮肤刺激、伤口裂开以及因感染导致的翻修手术发生率。将使用Cochrane偏倚风险工具2.0和Jadad评分来评估研究方法的质量。将使用统计分析来评估纳入研究之间的不一致性和偏倚。将汇总可比的结局数据,并根据情况进行定量或定性分析。

伦理与传播

本研究无需伦理批准。本系统评价和荟萃分析将发表在同行评审期刊上。

要点

人们已经研究了各种局部治疗策略以降低痤疮丙酸杆菌的感染率,痤疮丙酸杆菌是人工关节周围肩关节感染最常见的可识别病因,其中一些策略在减少阳性培养方面显示出疗效。本系统评价和荟萃分析评估了局部制剂在降低肩部手术中痤疮丙酸杆菌感染率方面的有效性。我们的主要结局是痤疮丙酸杆菌的菌落形成单位数量。

注册

PROSPERO 2022 CRD42022310312

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J Shoulder Elbow Surg. 2020 May;29(5):867-873. doi: 10.1016/j.jse.2019.12.032.
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Addition of 3% hydrogen peroxide to standard skin preparation reduces Cutibacterium acnes-positive culture rate in shoulder surgery: a prospective randomized controlled trial.向标准皮肤准备中添加 3%过氧化氢可降低肩关节手术中痤疮丙酸杆菌阳性培养率:一项前瞻性随机对照试验。
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