Jahangir Fereidoun, Haghdoost AliAkbar, Moameri Hossein, Okhovati Maryam
Department of Epidemiology and Biostatistics, School of Public Health, Kerman University of Medical Sciences, Kerman, Iran.
Department of Nursing, Hazrat Zahra (P.B.U.H) Abadeh School of Nursing, Shiraz University of Medical Sciences, Shiraz, Iran.
Iran J Med Sci. 2024 Jul 1;49(7):402-412. doi: 10.30476/ijms.2024.100819.3338. eCollection 2024 Jul.
Abdominal surgery is considered a high-risk procedure for the development of surgical site infection (SSI). Few studies have evaluated the relative importance of surgical site infection risk factors in terms of consistency in abdominal surgery. Therefore, this comprehensive review article mapped and summarized the evidence aimed to determine the relative importance of the risk factors and incidence of SSIs in abdominal surgery.
A literature review was conducted using electronic databases and search engines such as Scopus, PubMed, and Web of Science up to March 16, 2023. There was no language restriction for the papers to be included in the study. The relative consistency of the risk factors was measured and evaluated using the methodology of the Joanna Briggs Institute. Original peer-reviewed cohort and case-control studies were included if all types of SSIs were included. Meta-analysis was performed to determine the pooled estimates of SSI incidences.
Of 14,237 identified records, 107 articles were included in the review. The pooled incidence of SSI was 10.6% (95% CI: 9.02-12.55%, χ=12986.44, P<0.001). Operative time and higher wound class were both significant consistent risk factors for SSI incidence. Patients' educational status, malnutrition, functional status, and history of neurological/psychiatric disorders were all candidates for consistent risk factors, with insufficient evidence.
The findings of the present study indicated that SSI in abdominal surgery was a multifactorial phenomenon with a considerable risk and had different risk factors with various relative importance. Determining the relative importance of the risk factors for the prevention and control of SSI is strongly recommended.This manuscript has been released as a preprint at the research square: (https://doi.org/10.21203/rs.3.rs-3219597/v1).
腹部手术被认为是手术部位感染（SSI）发生的高风险手术。很少有研究从腹部手术的一致性方面评估手术部位感染风险因素的相对重要性。因此，这篇综述文章梳理并总结了旨在确定腹部手术中风险因素的相对重要性和手术部位感染发生率的证据。
截至2023年3月16日，使用电子数据库和搜索引擎（如Scopus、PubMed和Web of Science）进行文献综述。纳入研究的论文没有语言限制。使用乔安娜·布里格斯研究所的方法测量和评估风险因素的相对一致性。如果纳入了所有类型的手术部位感染，则纳入原始的同行评审队列研究和病例对照研究。进行荟萃分析以确定手术部位感染发生率的合并估计值。
在14237条检索到的记录中，107篇文章被纳入综述。手术部位感染的合并发生率为10.6%（95%CI：9.02 - 12.55%，χ=12986.44，P<0.001）。手术时间和较高的伤口等级都是手术部位感染发生率的显著一致风险因素。患者的教育状况、营养不良、功能状态以及神经/精神疾病史均为一致风险因素的候选因素，但证据不足。
本研究结果表明，腹部手术中的手术部位感染是一种多因素现象，风险相当大，且具有不同相对重要性的不同风险因素。强烈建议确定风险因素的相对重要性以预防和控制手术部位感染。本文已作为预印本在Research Square上发表：(https://doi.org/10.21203/rs.3.rs-3219597/v1) 。
