Ren Yu, Yu Hui, Wang Zhangfu, Pan Wenjun, Chen Lin, Luo Hua
Department of Pharmacy, Taizhou Hospital of Zhejiang Province affiliated to Wenzhou Medical University, Taizhou, Zhejiang, China.
Department of Hematology, Taizhou Hospital of Zhejiang Province affiliated to Wenzhou Medical University, Taizhou, Zhejiang, China.
EFORT Open Rev. 2024 Jun 3;9(6):458-466. doi: 10.1530/EOR-23-0062.
For many decades, patients recovering from wound closure have been instructed not to bathe. Although studies have shown that earlier postoperative bathing does not increase the risk of wound infection, it remains rare in practice for patients to be allowed earlier postoperative bathing. We performed this meta-analysis to determine how earlier bathing affected rates of wound infection, other complications, and patient satisfaction.
This systematic review conforms to PRISMA guidelines. The PubMed, EMBASE, Medline, Web of Science, and the Cochrane Central Register of Controlled Trials were searched from their inception dates to December 31, 2022. We estimated pooled values for the efficacy of trial of earlier bathing versus delayed bathing using the odds ratio and their associated 95% CI, and we used the I 2 statistic to assess heterogeneity between studies contributing to these estimates.
Of the 1813 articles identified by our search, 11 randomized controlled trials including 2964 patients were eligible for inclusion. The incidence of wound infection did not differ significantly between the earlier bathing and delayed bathing groups, nor did rates of other wound complications such as redness and swelling, or wound dehiscence. However, the incidence of hematoma in the delayed bathing group was higher than in the earlier bathing group. Reported patient satisfaction was significantly higher in the earlier bathing group.
The medical community, health authorities, and government should create and disseminate clinical practice guidelines to guide patients to evidence-based beneficial treatment.
几十年来,伤口缝合后康复的患者一直被指示不要洗澡。尽管研究表明术后更早洗澡不会增加伤口感染的风险,但在实际操作中,允许患者术后更早洗澡的情况仍然很少见。我们进行了这项荟萃分析,以确定更早洗澡如何影响伤口感染率、其他并发症以及患者满意度。
本系统评价符合PRISMA指南。检索了PubMed、EMBASE、Medline、Web of Science和Cochrane对照试验中央注册库,检索时间从各数据库建库日期至2022年12月31日。我们使用比值比及其相关的95%置信区间估计更早洗澡试验与延迟洗澡试验疗效的合并值,并使用I²统计量评估这些估计值所纳入研究之间的异质性。
在我们检索到的1813篇文章中,有11项随机对照试验(包括2964名患者)符合纳入标准。更早洗澡组和延迟洗澡组的伤口感染发生率没有显著差异,其他伤口并发症(如发红、肿胀或伤口裂开)的发生率也没有差异。然而,延迟洗澡组的血肿发生率高于更早洗澡组。更早洗澡组报告的患者满意度显著更高。
医学界、卫生当局和政府应制定并传播临床实践指南,以指导患者接受基于证据的有益治疗。