Shrestha Oshan, Basukala Sunil, Bhugai Nabaraj, Bohara Sujan, Bhatt Ayush, Thapa Niranjan, Paudel Sushanta, Joshi Niraj, Mehta Bipin, Acharya Astutee, Shrestha Nirakar
Department of Cardiothoracic and Vascular Anaesthesiology, Manmohan Cardiothoracic Vascular and Transplant Center, Kathmandu.
Department of Cardiovascular Surgery, Shahid Gangalal National Heart Centre.
Int J Surg. 2024 Nov 1;110(11):7341-7352. doi: 10.1097/JS9.0000000000001993.
Postprocedural infection has been a top priority for the perioperative team. The use of sterile gloves to counter this became popular and was routinely used, but randomized studies have shown that the benefit that was thought to be added by the use of sterile gloves is insignificant and that not all procedures require the use of sterile gloves.
Prospective protocol registration was and electronic databases were searched without using any search filters. Screening was performed by independent reviewers, and data was extracted from selected studies. Heterogeneity was assessed by the I2 test, and the effect model was chosen accordingly. The odds ratio was used as an effect measure as the variables in this study were dichotomous. Forest plots and funnel plots were used to give visual feedback.
This meta-analysis included 14 comparative studies that involved a total of 12,625 patients. Analysis of postprocedural infection outcome showed no significant difference between the procedure performed using sterile gloves and without using sterile gloves (OR: 0.88; 95% CI: 0.71-1.10; n =12,625; I2 =0%; P -value=0.26). Sensitivity analysis and subgroup analysis for randomized studies only, surgical site infection, and patients that did not receive prophylactic antibiotics showed no variations. The use of sterile gloves did not show any extra benefit for controlling infection during wound repair, excision and suturing, cystoscopy, and urinary catheterization.
The use of sterile gloves does not have any extra benefit for preventing infections when minor surgical procedures are performed.
术后感染一直是围手术期团队的首要关注问题。使用无菌手套来应对这一问题变得流行且被常规使用,但随机研究表明,人们认为使用无菌手套所带来的益处并不显著,而且并非所有手术都需要使用无菌手套。
进行前瞻性方案注册,并在不使用任何搜索过滤器的情况下检索电子数据库。由独立评审员进行筛选,并从选定的研究中提取数据。通过I²检验评估异质性,并据此选择效应模型。由于本研究中的变量为二分变量,因此使用比值比作为效应量度。使用森林图和漏斗图来提供直观反馈。
该荟萃分析纳入了14项比较研究,共涉及12,625例患者。对术后感染结果的分析表明,使用无菌手套进行的手术与不使用无菌手套进行的手术之间没有显著差异(比值比:0.88;95%置信区间:0.71 - 1.10;n = 12,625;I² = 0%;P值 = 0.26)。仅针对随机研究、手术部位感染以及未接受预防性抗生素治疗的患者进行的敏感性分析和亚组分析均未显示出差异。在伤口修复、切除和缝合、膀胱镜检查以及导尿过程中,使用无菌手套在控制感染方面并未显示出任何额外益处。
在进行小型外科手术时,使用无菌手套在预防感染方面没有任何额外益处。