Bai Dunyao, Zhou Fan, Wu Liuting
Department of Pharmacy, Puren Hospital Affiliated to Wuhan University of Science and Technology, Wuhan, China.
Laboratory of Molecular Medicine, Puren Hospital Affiliated to Wuhan University of Science and Technology, Wuhan, China.
Int Wound J. 2023 Oct 27;21(2). doi: 10.1111/iwj.14463.
Surgical site infections (SSIs) post-surgery impact patient health and raise healthcare costs. This meta-analysis examines the efficacy of antiseptics, chlorhexidine and povidone-iodine, in reducing SSIs, including various types, to settle ongoing debates on their comparative effectiveness. A systematic literature search conforming to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines was executed on four established databases without temporal restrictions. Only randomized controlled trials (RCTs) including patients aged 18 years or older undergoing clean or potentially contaminated surgeries were included. Two independent evaluators carried out study selection, data extraction and quality assessment, adhering to Cochrane Collaboration's risk of bias tool. Statistical analyses were performed using chi-square tests and the I index to evaluate heterogeneity, and meta-analyses were conducted employing either fixed-effects or random-effects models as warranted by the heterogeneity assessments. A total of 16 RCTs were included after rigorous selection from an initial pool of 1742 articles. The studies demonstrated low levels of heterogeneity, supporting the use of a fixed-effects model. Chlorhexidine exhibited statistically lower rates of overall SSIs (RR 0.75; 95% CI 0.64-0.88; p < 0.001), superficial SSIs (RR 0.62; 95% CI 0.47-0.82; p < 0.001) and deep SSIs compared to povidone-iodine. The study furnishes compelling evidence in favour of chlorhexidine as a more efficacious antiseptic agent over povidone-iodine in minimizing the risk of various types of SSIs.
手术后手术部位感染（SSIs）会影响患者健康并增加医疗成本。本荟萃分析旨在检验防腐剂洗必泰和聚维酮碘在降低包括各种类型的SSIs方面的疗效，以解决关于它们相对有效性的持续争论。按照系统评价和荟萃分析的首选报告项目（PRISMA）指南，在四个既定数据库上进行了无时间限制的系统文献检索。仅纳入了包括18岁及以上接受清洁或可能污染手术患者的随机对照试验（RCTs）。两名独立评估人员按照Cochrane协作网的偏倚风险工具进行研究筛选、数据提取和质量评估。使用卡方检验和I指数进行统计分析以评估异质性，并根据异质性评估结果采用固定效应或随机效应模型进行荟萃分析。从最初的1742篇文章中严格筛选后，共纳入16项RCTs。这些研究显示异质性水平较低，支持使用固定效应模型。与聚维酮碘相比，洗必泰在总体SSIs（RR 0.75；95%CI 0.64 - 0.88；p＜0.001）、浅表SSIs（RR 0.62；95%CI 0.47 - 0.82；p＜0.001）和深部SSIs方面的发生率在统计学上更低。该研究提供了有力证据，表明在降低各种类型SSIs风险方面，洗必泰作为一种防腐剂比聚维酮碘更有效。
