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妇科肿瘤外科手术部位感染预防套件:实施加速康复外科(ERAS)方案的关键要素。

Surgical site infection prevention bundle in gynecology oncology surgery: a key element in the implementation of an enhanced recovery after surgery (ERAS) program.

机构信息

Division of Gynecologic Surgery, European Institute of Oncology, Milan, Italy

Department of Obstetrics and Gynecology, Houston Methodist Hospital Neal Cancer Center, Houston, Texas, USA.

出版信息

Int J Gynecol Cancer. 2024 Sep 2;34(9):1445-1453. doi: 10.1136/ijgc-2024-005423.

Abstract

Surgical site infection rates are among 5-35% in all gynecologic oncology procedures. Such infections lead to increased patient morbidity, reduction in quality of life, higher likelihood of readmissions, and reinterventions, which contribute directly to mortality and increase in health-related costs. Some of these are potentially preventable by applying evidence-based strategies in the peri-operative patient setting. The objective of this review is to provide recommendations for the individual components that most commonly comprise the surgical site infection prevention bundles that could be implemented in gynecologic oncology procedures. We searched articles from relevant publications with specific topics related to each surgical site infection intervention chosen to be reviewed. Studies on each topic were selected with an emphasis on meta-analyses, systematic reviews, randomized control studies, non-randomized controlled studies, reviews, clinical practice guidelines, and case series. Data synthesis was done through content and thematic analysis to identify key themes in the included studies. This review intends to serve as the most up-to-date frame of evidence-based peri-operative care in our specialty and could serve as the first initiative to introduce an enhanced recovery after surgery (ERAS) program.

摘要

手术部位感染率在所有妇科肿瘤学手术中为 5-35%。此类感染会导致患者发病率增加、生活质量下降、再次入院和再次干预的可能性增加,这直接导致死亡率上升和医疗相关成本增加。通过在围手术期患者环境中应用基于证据的策略,其中一些感染是可以预防的。本综述的目的是为妇科肿瘤学手术中最常见的手术部位感染预防措施的各个组成部分提供建议。我们从与每个选择进行综述的手术部位感染干预措施相关的相关出版物中搜索文章。每个主题的研究都选择了重点放在荟萃分析、系统评价、随机对照研究、非随机对照研究、综述、临床实践指南和病例系列上。通过内容和主题分析对数据进行综合,以确定纳入研究中的关键主题。本综述旨在成为我们专业领域最新的循证围手术期护理框架,并可以作为引入手术后加速康复(ERAS)计划的第一个举措。

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