Lu Xuanjiao, Li Jun
Department of Joint Surgery Diagnosis and Treatment Center, The Central Hospital of Enshi Tujia and Miao Autonomous Prefecture, Enshi, China.
Int Wound J. 2023 Oct 26;21(2). doi: 10.1111/iwj.14436.
This meta-analysis evaluated the effect of enhanced recovery after surgery (ERAS) nursing on the incidence surgical site wound infection in older adults with hip fractures. The PubMed, Embase, the Cochrane Library, Web of Science, China Biomedical Literature Database, Wanfang, China National Knowledge Infrastructure, and VIP databases were searched from inception up to March 2023 for articles on randomized controlled trials (RCTs) on the effect of ERAS nursing on surgical site wound infection in older adults with hip fractures. Patients in the experimental group received ERAS nursing, and patients in the control group received conventional postoperative nursing. Two researchers independently completed literature screening and data extraction. The included articles were evaluated according to Cochrane quality assessment standards and the meta-analysis was conducted using Stata 17.0 software to calculate the effect sizes and their 95% confidence intervals (CIs). Twelve RCTs were included with 1117 patients, including 559 in the experimental group and 558 in the control group. In older adults with hip fractures, ERAS nursing reduced the risk of surgical site wound infection (odds ratio [OR]: 0.26, 95% CI: 0.11-0.58, p = 0.001) and postoperative complications (OR: 0.22, 95% CI: 0.14-0.33, p < 0.001), and reduced the length of hospital stay (mean difference: -4.04 days, 95% CI: -4.33 to -3.76 days, p < 0.001). In older adults with hip fractures, ERAS nursing reduces the incidence of surgical site infection and complications and shortens the length of hospital stay.
本荟萃分析评估了术后加速康复(ERAS)护理对老年髋部骨折患者手术部位伤口感染发生率的影响。检索了PubMed、Embase、Cochrane图书馆、Web of Science、中国生物医学文献数据库、万方、中国知网和维普数据库,从建库至2023年3月,查找关于ERAS护理对老年髋部骨折患者手术部位伤口感染影响的随机对照试验(RCT)文章。实验组患者接受ERAS护理,对照组患者接受常规术后护理。两名研究人员独立完成文献筛选和数据提取。根据Cochrane质量评估标准对纳入的文章进行评估,并使用Stata 17.0软件进行荟萃分析,以计算效应量及其95%置信区间(CI)。纳入12项RCT,共1117例患者,其中实验组559例,对照组558例。在老年髋部骨折患者中,ERAS护理降低了手术部位伤口感染风险(比值比[OR]:0.26,95%CI:0.11 - 0.58,p = 0.001)和术后并发症风险(OR:0.22,95%CI:0.14 - 0.33,p < 0.001),并缩短了住院时间(平均差值:-4.04天,95%CI:-4.33至-3.76天,p < 0.001)。对于老年髋部骨折患者,ERAS护理可降低手术部位感染和并发症的发生率,并缩短住院时间。