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一项荟萃分析研究了局部护理应用抗菌药物作为结直肠手术预防手术部位感染的效果。

A meta-analysis examined the effect of topical nursing application of antimicrobial as a prophylaxis for the stoppage of surgical wound infection in colorectal surgery.

机构信息

School of Nursing, Jilin University, Jilin, P.R. China.

Department of Traditional Chinese Medicine, Bethune First Hospital of Jilin University, Changchun, P.R. China.

出版信息

Int Wound J. 2023 Aug;20(6):2010-2019. doi: 10.1111/iwj.14064. Epub 2023 Feb 2.

Abstract

To assess the impact of topical antimicrobial (TA) as a prophylaxis for the stoppage of surgical wound infection (SWI) in colorectal surgery (CS), we lead a meta-analysis. 9160 participants with CS were enrolled in the chosen studies; 4719 of them used TA, while 4441 served as controls. To assess the effectiveness of TA application in lowering SWIs following CS, odds ratios (OR) with 95% confidence intervals (CIs) were computed with a dichotomous technique with a fixed- or random-effect model. Significantly lower SWIs post CS for TA as whole (OR, 0.50; 95% CI, 0.38-0.64; P < .001), gentamicin collagen sponge and beads (OR, 0.52; 95% CI, 0.32-0.86; P = .01), triclosan impregnated fascial suture (OR, 0.57; 95% CI, 0.38-0.84; P = .005), antibiotic powder, ointment, lavage, or injection for the abdominal wound (OR, 0.35; 95% CI, 0.21-0.59; P < .001), and ionised silver dressing on the closed abdominal wound (OR, 0.45; 95% CI, 0.27-0.77; P = .003) compared to control. Significantly lower SWIs post CS for TA as a whole, gentamicin collagen sponge and beads, triclosan impregnated fascial sutures, antibiotic powder, ointment, lavage, or injection for the abdominal wound, and ionised silver dressing on the closed abdominal wound compared with control. The low sample size of 8 out of the 39 included studies in this meta-analysis calls for precaution when analysing the outcomes.

摘要

为了评估局部抗菌(TA)作为结直肠手术(CS)中预防手术部位感染(SWI)的效果,我们进行了一项荟萃分析。选择了 9160 名接受 CS 的参与者;其中 4719 名使用 TA,4441 名为对照组。为了评估 TA 在 CS 后降低 SWI 的有效性,我们使用二项式技术,采用固定或随机效应模型计算比值比(OR)及其 95%置信区间(CI)。TA 整体(OR,0.50;95%CI,0.38-0.64;P<0.001)、庆大霉素胶原海绵和珠(OR,0.52;95%CI,0.32-0.86;P=0.01)、三氯生浸渍筋膜缝合线(OR,0.57;95%CI,0.38-0.84;P=0.005)、抗生素粉末、软膏、冲洗液或腹部伤口注射剂(OR,0.35;95%CI,0.21-0.59;P<0.001)以及闭合腹部伤口的离子银敷料(OR,0.45;95%CI,0.27-0.77;P=0.003)与对照组相比,SWI 显著降低。TA 整体、庆大霉素胶原海绵和珠、三氯生浸渍筋膜缝合线、抗生素粉末、软膏、冲洗液或腹部伤口注射剂以及闭合腹部伤口的离子银敷料与对照组相比,SWI 显著降低。该荟萃分析中,39 项纳入研究中只有 8 项的样本量较小,因此在分析结果时需要谨慎。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e297/10333037/0b5075acba1e/IWJ-20-2010-g001.jpg

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