Whipps Cross Hospital, Barts Health NHS Trust, UK.
Ann R Coll Surg Engl. 2022 Sep;104(8):571-576. doi: 10.1308/rcsann.2022.0075.
Surgical site infections (SSIs) remain a significant cause of morbidity for surgical patients worldwide and with growing rates of antibiotic resistance, the development of new nonantimicrobial techniques to target SSI reduction is crucial. This review aimed to explore available nonantibiotic intraoperative interventions to reduce the risk of SSI.
A literature search was undertaken using Medline, Web of Science, Embase, and Cochrane Library databases. Any study published from 1 January 1980 to 1 September 2021 that described any nonantibiotic intraoperative physical technique aiming to reduce SSI rates, with a primary or secondary outcome of SSI rates, was included.
A total of 45 articles were included in the final scoping review. The current nonantibiotic intraoperative interventions advised for use include chlorhexidine skin preparation with alcohol, pressurised wound irrigation, Triclosan-coated sutures for skin closure, and negative pressure wound therapy. Many other widely used surgical practices do not have the supporting evidence to validate their routine use in clinical practice to reduce SSI rates.
We identified several techniques that can be used in the operating theatre to provide additional opportunities to reduce SSI rates. However, strict adherence to current established SSI prevention guidelines remains the mainstay of ensuring SSI rates remain low.
手术部位感染（SSI）仍然是全球外科患者发病率的一个重要原因，而且随着抗生素耐药率的不断上升，开发新的非抗菌技术来降低 SSI 的风险至关重要。本综述旨在探讨现有的非抗生素术中干预措施，以降低 SSI 的风险。
使用 Medline、Web of Science、Embase 和 Cochrane Library 数据库进行文献检索。纳入了自 1980 年 1 月 1 日至 2021 年 9 月 1 日发表的任何描述旨在降低 SSI 发生率的任何非抗生素术中物理技术的研究，其主要或次要结局为 SSI 发生率。
最终的范围综述共纳入了 45 篇文章。目前建议使用的非抗生素术中干预措施包括用酒精进行氯己定皮肤准备、加压伤口冲洗、用于皮肤缝合的三氯生涂层缝线和负压伤口治疗。许多其他广泛使用的外科手术实践没有支持证据来验证其在临床实践中常规使用以降低 SSI 发生率的合理性。
我们确定了几种可在手术室中使用的技术，这些技术为降低 SSI 发生率提供了额外的机会。然而，严格遵守现有的既定 SSI 预防指南仍然是确保 SSI 发生率保持较低水平的主要方法。
