Peristeri Dimitra V, Nour Hussameldin M, Ahsan Amiya, Abogabal Sameh, Singh Krishna K, Sajid Muhammad Shafique
Department of Gastrointestinal Surgery, Brighton and Sussex University Hospitals NHS Trust, Brighton, UK.
Department of Gastrointestinal Surgery, Brighton and Sussex University Hospitals NHS Trust, Brighton, UK.
J Surg Res. 2023 Nov;291:734-741. doi: 10.1016/j.jss.2023.06.011. Epub 2023 Aug 11.
The use of optimal skin antiseptic agents for the prevention of surgical site infection (SSI) is of critical importance, especially during abdominal surgical procedures. Alcohol-based chlorhexidine gluconate (CHG) and aqueous-based povidone-iodine (PVI) are the two most common skin antiseptics used nowadays. The objective of this article is to evaluate the effectiveness of alcohol-based CHG versus aqueous-based PVI used for skin preparation before abdominal surgery to reduce SSIs.
Standard medical databases such as MEDLINE, Embase, Pubmed, and Cochrane Library were searched to find randomized, controlled trials comparing alcohol-based CHG skin preparation versus aqueous-based PVI in patients undergoing abdominal surgery. The combined outcomes of SSIs were calculated using odds ratio with 95% confidence intervals. All data were analyzed using Review Manager Software 5.4, and the meta-analysis was performed with a random effect model analysis.
A total of 11 studies, all randomized, controlled trials, were included (n = 12,072 participants), recruiting adult patients undergoing abdominal surgery. In the random effect model analysis, the use of alcohol-based CHG in patients undergoing abdominal surgery was associated with a reduced risk of SSI compared to aqueous-based PVI (odds ratio: 0.84; 95% confidence interval [0.74, 0.96], z = 2.61, P = 0.009).
Alcohol-based CHG may be more effective for preventing the risk of SSI compared to aqueous-based PVI agents in abdominal surgery. The conclusion of this meta-analysis may add a guiding value to reinforce current clinical practice guidelines.
使用最佳皮肤消毒剂预防手术部位感染（SSI）至关重要，尤其是在腹部外科手术过程中。酒精基葡萄糖酸氯己定（CHG）和水基聚维酮碘（PVI）是目前使用的两种最常见的皮肤消毒剂。本文的目的是评估在腹部手术前用于皮肤准备的酒精基CHG与水基PVI相比，在降低SSI方面的有效性。
检索MEDLINE、Embase、Pubmed和Cochrane图书馆等标准医学数据库，以查找比较腹部手术患者中酒精基CHG皮肤准备与水基PVI的随机对照试验。使用比值比及95%置信区间计算SSI的综合结果。所有数据均使用Review Manager Software 5.4进行分析，并采用随机效应模型分析进行荟萃分析。
共纳入11项研究，均为随机对照试验（n = 12,072名参与者），纳入接受腹部手术的成年患者。在随机效应模型分析中，与水基PVI相比，腹部手术患者使用酒精基CHG与SSI风险降低相关（比值比：0.84；95%置信区间[0.74, 0.96]，z = 2.61，P = 0.009）。
在腹部手术中，与水基PVI制剂相比，酒精基CHG在预防SSI风险方面可能更有效。该荟萃分析的结论可能会为加强当前临床实践指南增添指导价值。
