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成人左心室辅助装置植入手术中预防手术伤口感染的围手术期干预措施:一项范围综述。

Perioperative interventions for the prevention of surgical wound infection in adult patients undergoing left ventricular assist devices implantation: A scoping review.

作者信息

Brandão Sara Michelly Gonçalves, Urasaki Maristela Belletti Mutt, Lemos Dayanna Machado Pires, Matos Ligia Neres, Takahashi Mariana, Nogueira Paula Cristina, de Gouveia Santos Vera Lucia Conceição

机构信息

Instituto do Coracao (InCor) do Hospital das Clinicas da Faculdade de Medicina da Universidade de Sao Paulo, Sao Paulo, SP, Brazil.

Escola de Artes, Ciências e Humanidades da Universidade de Sao Paulo, Sao Paulo, SP, Brazil.

出版信息

Intensive Crit Care Nurs. 2024 Jun;82:103658. doi: 10.1016/j.iccn.2024.103658. Epub 2024 Mar 2.

Abstract

BACKGROUND

Surgical wound infection is the most frequent type of care health associated infection. Lack of knowledge about the prevention of surgical wound infection in patients undergoing left ventricular assist device implantation could significantly undermine the potential benefits of surgical intervention.

OBJECTIVES

This study aimed to map the recommendations for adult patients undergoing left ventricular assist device implantation.

DESIGN

This is a scoping review, being registered in the Open Science Framework under DOI https://doi.org/10.17605/OSF.IO/Q76B3 (https://osf.io/q76b3/).

METHOD

Left ventricular assist device coordinators and nurse specialists in dermatology and stomatherapy conducted a scoping review in Scopus, The Cochrane Database of Systematic Reviews, Cumulative Index to Nursing and Allied Health Literature (CINAHL), limited to the period between 2015 and 2022. The results of this scoping review will be discussed and presented in separate articles. This paper will synthesize research evidence on the perioperative topic.

RESULTS

The initial searches resulted in 771 studies. Sixty nine met the eligibility criteria and were included in the scoping review. Eight articles addressing the perioperative topic that answered the question of this article were included.

CONCLUSION

Although this scoping review included heterogeneous, and scarce studies with left ventricular assist device patients. As such, there are many promising future research directions for this topic.

IMPLICATIONS FOR CLINICAL PRACTICE

Infection surveillance should be an integral part of left ventricular assist device implantation programs in health care institutions. Velvet completely buried in subcutaneous tissues reduces transmission system infection. Triple tunnel method reduces transmission system infection risk.

摘要

背景

手术伤口感染是医疗相关感染中最常见的类型。对于接受左心室辅助装置植入手术的患者,缺乏预防手术伤口感染的知识可能会显著削弱手术干预的潜在益处。

目的

本研究旨在梳理针对接受左心室辅助装置植入手术的成年患者的相关建议。

设计

这是一项范围综述,已在开放科学框架下注册,DOI为https://doi.org/10.17605/OSF.IO/Q76B3(https://osf.io/q76b3/)。

方法

左心室辅助装置协调员以及皮肤科和口腔治疗的护士专家在Scopus、Cochrane系统评价数据库、护理及相关健康文献累积索引(CINAHL)中进行了范围综述,时间限制在2015年至2022年之间。该范围综述的结果将在单独的文章中进行讨论和呈现。本文将综合围手术期主题的研究证据。

结果

初步检索得到771项研究。69项符合纳入标准并被纳入范围综述。纳入了8篇涉及围手术期主题且回答了本文问题的文章。

结论

尽管这项范围综述纳入的研究存在异质性且针对左心室辅助装置患者的研究较少。因此,该主题有许多有前景的未来研究方向。

对临床实践的启示

感染监测应成为医疗机构左心室辅助装置植入项目的一个组成部分。完全埋入皮下组织的天鹅绒可减少传输系统感染。三隧道法可降低传输系统感染风险。

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