Department of Surgery, Klinikum rechts der Isar, School of Medicine, Technical University of Munich, Munich, Germany
Department of Surgery, Klinikum rechts der Isar, School of Medicine, Technical University of Munich, Munich, Germany.
BMJ Open. 2023 Feb 14;13(2):e066140. doi: 10.1136/bmjopen-2022-066140.
Surgical site infection (SSI) after laparotomy still represents the most frequent postoperative complicationin abdominal surgery. The effectiveness of reducing SSI rates by intra-operative irrigation of the incisional wound with antiseptic solutions or saline has been much debated, and recommendations on its use are divergent. Therefore, we aim to conduct a systematic review and meta-analysis, focusing specifically on procedures by laparotomy and considering recent evidence only.
The systematic review and meta-analysis were conducted in accordance with the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P) statement. On 1 July 2022, PubMed/MEDLINE, Cochrane, Central Register of Controlled Trials and EMBASE were searched for the following predefined terms: (Surgical site infection) AND ((irrigation) OR (wound irrigation) OR (lavage)) AND ((abdominal surgery) OR (laparotomy). The search was limited to peer-revied publications, dating after 1 January 2000 in English or German language. Systematic reviews and meta-analyses were included for reference screening. Case reports, case series, non-systematic reviews and studies without follow-up information were excluded. The primary outcome is the rate of postoperative SSI after abdominal surgery by laparotomy. Meta-analysis is pooled using the Mantel-Haenszel method for random effects. The risk of bias in randomised studies will be assessed using the Cochrane developed RoB 2-tool, and the ROBINS-I tool for non-randomised studies. Completion of the analysis and publication is planned in March 2023.
Ethical approval is not necessary for this study, as no new data will be collected. The results of the final study will be published in a peer-reviewed open-access journal.
CRD42022321458.
剖腹术后手术部位感染（SSI）仍然是腹部手术中最常见的术后并发症。术中用抗菌溶液或生理盐水冲洗切口来降低 SSI 发生率的有效性存在很大争议，其使用建议也存在分歧。因此，我们旨在进行一项系统评价和荟萃分析，专门关注剖腹术相关的程序，并仅考虑最近的证据。
系统评价和荟萃分析是根据系统评价和荟萃分析报告的首选项目（PRISMA-P）声明进行的。2022 年 7 月 1 日，检索了 PubMed/MEDLINE、Cochrane、对照试验注册中心和 EMBASE，使用以下预定义术语：（手术部位感染）和（（冲洗）或（伤口冲洗）或（灌洗））和（（腹部手术）或（剖腹术）。检索仅限于同行评审出版物，发表日期在 2000 年 1 月 1 日之后，语言为英语或德语。系统评价和荟萃分析被纳入参考筛选。病例报告、病例系列、非系统评价和无随访信息的研究被排除在外。主要结局是剖腹术后腹部手术的术后 SSI 发生率。使用 Mantel-Haenszel 方法对随机效应进行荟萃分析。使用 Cochrane 开发的 RoB 2 工具评估随机研究的偏倚风险，以及非随机研究的 ROBINS-I 工具。计划于 2023 年 3 月完成分析和发表。
这项研究不需要伦理批准，因为不会收集新数据。最终研究的结果将发表在同行评议的开放获取期刊上。
PROSPERO 注册号：CRD42022321458。
