Student Research Committee, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
School of Medicine, Islamic Azad University, Mashhad Branch, Mashhad, Iran.
Int Wound J. 2024 Feb;21(2):e14765. doi: 10.1111/iwj.14765.
The present systematic review and meta-analysis aimed to determine the prevalence of surgical site infection (SSI) and risk factors in patients after knee surgery. A comprehensive and systematic search was carried out across various international electronic databases, including Scopus, PubMed and Web of Science, as well as Persian electronic databases like Iranmedex and the Scientific Information Database (SID). This search involved the utilization of keywords derived from Medical Subject Headings, such as 'Prevalence', 'Surgical wound infection', 'Surgical site infection' and 'Orthopaedics', spanning from the earliest records up to 1 October 2023. To assess the quality of the included studies, the Appraisal tool for Cross-Sectional Studies (AXIS tool) was utilized. The study encompassed a combined participant pool of 11 028 individuals who underwent knee surgery across seven selected studies. The collective prevalence of SSI in patients who underwent knee surgery, as reported in the seven included studies, was determined to be 3.0% (95% CI: 1.2% to 7.5%; I = 96.612%; p < 0.001). The combined prevalence of SSI in patients with DM, as reported in six studies, was 5.1% (95% CI: 1.7% to 14.5%; I = 79.054%; p < 0.001). Similarly, the pooled prevalence of SSI in patients with HTN, drawn from four studies, was 1.8% (95% CI: 0.7% to 4.5%; I = 63.996%; p = 0.040). Additionally, the collective prevalence of SSI in patients with a history of tobacco use, based on findings from six studies, was 4.8% (95% CI: 1.4% to 15.2%; I = 93.358%; p < 0.001). Subgroup analysis was conducted within six studies, categorizing them by two countries, namely China and the USA. These analyses revealed that the prevalence of SSI following knee surgery was 3.0% in China and 2.0% in the USA. It is noteworthy that variations in SSI prevalence across different studies may be attributed to a multitude of factors, particularly varying risk factors among patient populations. To address this issue and mitigate the impact of SSI on knee surgery patients, it is advisable to develop tailored interventions.
本系统评价和荟萃分析旨在确定膝关节手术后患者的手术部位感染（SSI）发生率和危险因素。通过对 Scopus、PubMed 和 Web of Science 等国际电子数据库以及伊朗 Medex 和科学信息数据库（SID）等波斯语电子数据库进行全面系统的搜索，利用来自医学主题词的关键词，如“流行”、“手术伤口感染”、“手术部位感染”和“骨科”，追溯到 2023 年 10 月 1 日的最早记录。为了评估纳入研究的质量，使用了横断面研究评估工具（AXIS 工具）。该研究共纳入了 7 项研究中 11028 名接受膝关节手术的患者。在纳入的 7 项研究中，报告的膝关节手术后患者 SSI 的总体发生率为 3.0%（95%CI：1.2%至 7.5%；I²=96.612%；p<0.001）。在 6 项研究中报告的糖尿病患者中 SSI 的合并发生率为 5.1%（95%CI：1.7%至 14.5%；I²=79.054%；p<0.001）。同样，在 4 项研究中报告的高血压患者中 SSI 的合并发生率为 1.8%（95%CI：0.7%至 4.5%；I²=63.996%；p=0.040）。此外，在 6 项研究中发现，有吸烟史的患者的 SSI 总发生率为 4.8%（95%CI：1.4%至 15.2%；I²=93.358%；p<0.001）。在 6 项研究中进行了亚组分析，将其分为中国和美国两个国家。这些分析表明，中国膝关节手术后 SSI 的发生率为 3.0%，美国为 2.0%。值得注意的是，不同研究中 SSI 发生率的差异可能归因于多种因素，特别是患者人群中不同的危险因素。为了解决这个问题并减轻 SSI 对膝关节手术患者的影响，建议制定有针对性的干预措施。
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