Cunha T, Miguel S, Maciel J, Zagalo C, Alves P
Faculty of Health Sciences and Nursing, Universidade Católica Portuguesa, Lisbon, Portugal; UL-PPCIRA, Instituto Português de Oncologia Francisco Gentil, Lisbon, Portugal.
Centre for Interdisciplinary Research in Health, Faculty of Health Sciences and Nursing, School of Nursing, Universidade Católica Portuguesa, Lisbon, Portugal.
J Hosp Infect. 2025 Jan;155:221-230. doi: 10.1016/j.jhin.2024.10.010. Epub 2024 Oct 31.
Surgical site infection (SSI) prevention bundles have been used to reduce infection rates in most types of surgery. Bundles tailored to colorectal surgery have been used with success.
To identify and review the individual interventions that constitute each SSI prevention care bundle in colorectal surgery, and the reduction in SSI rate associated with their implementation.
A scoping review was conducted in PubMed, CINAHL, Web of Science Core Collection and Scopus in December 2022.
This review analysed 48 of 164 identified studies on SSI prevention in colorectal surgery from 2011 to 2022. It revealed an average of 11 interventions per study, primarily in the pre-operative [mechanical bowel preparation, oral antibiotic bowel decontamination, hair removal, chlorhexidine gluconate (CHG) shower, normoglycaemia], intra-operative (antibiotic prophylaxis, normothermia, CHG skin preparation, antibiotic prophylaxis re-dosing, gown/glove change) and postoperative (normothermia, normoglycaemia, dressing removal, oxygen optimization, incision cleansing) periods. Despite these interventions, SSI rates remain high, indicating a need for further research to optimize intervention bundles and improve compliance across surgical stages.
The implementation of SSI prevention bundles, tailored to colorectal surgery, has shown a reduction in SSI rates and costs. Grouping interventions according to the peri-operative phase may increase compliance.
手术部位感染（SSI）预防集束化措施已被用于降低大多数类型手术的感染率。针对结直肠手术量身定制的集束化措施已取得成功应用。
确定并综述构成结直肠手术中每项SSI预防护理集束化措施的个体干预措施，以及与这些措施实施相关的SSI率降低情况。
2022年12月在PubMed、CINAHL、科学引文索引核心合集和Scopus数据库中进行了一项范围综述。
本综述分析了2011年至2022年期间164项已确定的关于结直肠手术中SSI预防研究中的48项。结果显示，每项研究平均有11项干预措施，主要分布在术前[机械性肠道准备、口服抗生素肠道去污、毛发去除、葡萄糖酸氯己定（CHG）沐浴、血糖正常化]、术中（抗生素预防、体温正常、CHG皮肤准备、抗生素预防再给药、更换手术衣/手套）和术后（体温正常、血糖正常化、拆除敷料、优化给氧、切口清洁）阶段。尽管采取了这些干预措施，但SSI率仍然很高，这表明需要进一步研究以优化干预集束化措施并提高手术各阶段的依从性。
针对结直肠手术量身定制的SSI预防集束化措施的实施已显示出SSI率和成本的降低。根据围手术期阶段对干预措施进行分组可能会提高依从性。
