Abdallah Shenouda, Hammoud Sabri M, Al Balushi Hamza, Loon Muhammad M, Salcedo Yoalkris E, Hassan Muhammad Mustaneer Ul, Cheema Muhammad J, Kadri Faizan, Shehryar Abdullah, Rehman Abdur, Ibrahim Muhammad
Surgery, Sheikh Jaber Al-Ahmad Al-Sabah Hospital, Kuwait City, KWT.
General Surgery, Sheikh Jaber Al-Ahmad Al-Sabah Hospital, Kuwait City, KWT.
Cureus. 2024 May 7;16(5):e59849. doi: 10.7759/cureus.59849. eCollection 2024 May.
Surgical site infections (SSIs) pose a significant clinical challenge, with heightened risks and severe consequences for diabetic patients undergoing surgical procedures. This systematic review aims to synthesize the current evidence on effective prevention strategies for mitigating SSI risk in this vulnerable population. From inception to March 2024, we comprehensively searched multiple electronic databases (PubMed, Medline, Embase, Cochrane Library, CINAHL) to identify relevant studies evaluating SSI prevention strategies in diabetic surgical patients. Our search strategy followed Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines, utilizing a combination of keywords and Medical Subject Headings (MeSH) terms related to diabetes, surgical site infections, prevention strategies, and surgical procedures. Inclusion criteria focused on peer-reviewed clinical trials, randomized controlled trials, and meta-analyses published in English. The search yielded three studies meeting the eligibility criteria, subject to data extraction and qualitative synthesis. Key findings highlighted the efficacy of interventions such as optimized perioperative glycemic control, timely prophylactic antibiotic administration, and meticulous preoperative skin antisepsis in reducing SSI rates among diabetic surgical patients. The potential for personalized prevention approaches based on individual patient factors, such as diabetes type and surgical complexity, was explored. This systematic review underscores the importance of a multifaceted, evidence-based approach to SSI prevention in diabetic surgical patients, integrating strategies like glycemic control, antibiotic prophylaxis, and preoperative skin antisepsis. Furthermore, our findings suggest the potential benefits of personalized care pathways tailored to individual patient characteristics. Implementing these interventions requires interdisciplinary collaboration, adaptation to diverse healthcare settings, and patient engagement through culturally sensitive education initiatives. This comprehensive analysis informs clinical practice, fosters patient safety, and contributes to the global efforts to enhance surgical outcomes for this high-risk population.
手术部位感染（SSIs）构成了重大的临床挑战，对于接受外科手术的糖尿病患者而言，其风险更高且后果严重。本系统评价旨在综合当前关于减轻这一脆弱人群手术部位感染风险的有效预防策略的证据。从开始到2024年3月，我们全面检索了多个电子数据库（PubMed、Medline、Embase、Cochrane图书馆、CINAHL），以识别评估糖尿病手术患者手术部位感染预防策略的相关研究。我们的检索策略遵循系统评价和Meta分析的首选报告项目（PRISMA）指南，使用与糖尿病、手术部位感染、预防策略和外科手术相关的关键词和医学主题词（MeSH）的组合。纳入标准侧重于以英文发表的同行评审临床试验、随机对照试验和Meta分析。检索产生了三项符合纳入标准的研究，随后进行数据提取和定性综合分析。主要研究结果强调了优化围手术期血糖控制、及时预防性使用抗生素以及细致的术前皮肤消毒等干预措施在降低糖尿病手术患者手术部位感染率方面的有效性。探讨了基于个体患者因素（如糖尿病类型和手术复杂性）的个性化预防方法的潜力。本系统评价强调了在糖尿病手术患者中采用多方面、基于证据的方法预防手术部位感染的重要性，整合血糖控制、抗生素预防和术前皮肤消毒等策略。此外，我们的研究结果表明了根据个体患者特征量身定制个性化护理路径的潜在益处。实施这些干预措施需要跨学科合作，适应不同的医疗环境，并通过具有文化敏感性的教育举措促进患者参与。这一全面分析为临床实践提供了信息，促进了患者安全，并为全球改善这一高危人群手术结局的努力做出了贡献。
