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膝关节和髋关节置换术中抗菌切口单:随机对照研究和前瞻性队列研究的Meta分析

Antimicrobial Incise Drapes in Knee and Hip Arthroplasties: Meta-analysis of Randomized Controlled and Prospective Cohort Studies.

作者信息

Pearl Adam, Awad Mohamed E, Hasan Ahmad I, Saleh Khaled J

机构信息

HCA Aventura Hospital, Department of Emergency Medicine, Miami, Florida.

NorthStar Anesthesia, Detroit Medical Center, Detroit, Michigan; Surgical Outcomes Research Institute, John D Dingell VA Medical Center, Detroit, Michigan; Michigan State University College of Osteopathic Medicine, Detroit, Michigan.

出版信息

J Surg Orthop Adv. 2024 Winter;33(4):206-211.

Abstract

Traditional skin preparation and prophylactic antibiotics have not uniformly been successful in preventing surgical site infection (SSI) following total joint arthroplasties. Iodophor-impregnated adhesive dressings, such as Ioban, have shown promising effects in reducing the incidence of SSI. A systematic review and meta-analysis were conducted according to PRISMA checklist and the Cochrane Handbook for Systematic Reviews of Interventions. Non-stratified and stratified meta-analysis were conducted to test for confounding and biases. The methodological quality and risk of bias were analyzed and appraised. Five studies including 1,655 patients were eligible. In these studies, 51.6% of the included patients had antimicrobial incise drape in the setting of knee and hip arthroplasties. Both non-stratified and stratified analyses revealed that the antimicrobial incise drape significantly reduced the risk of contamination as compared with no drape (odds ratio = 0.54, p < 0.0001). Iodophor-impregnated incise drapes, such as Ioban, significantly reduce the risk of contamination in total joint arthroplasties. (Journal of Surgical Orthopaedic Advances 33(4):206-211, 2024).

摘要

传统的皮肤准备和预防性抗生素在预防全关节置换术后手术部位感染(SSI)方面并非一直成功。含碘敷料,如Ioban,在降低SSI发生率方面显示出有前景的效果。根据PRISMA清单和《Cochrane干预措施系统评价手册》进行了系统评价和荟萃分析。进行了非分层和分层荟萃分析以检验混杂因素和偏倚。对方法学质量和偏倚风险进行了分析和评估。五项研究纳入1655例患者,符合条件。在这些研究中,纳入患者的51.6%在膝关节和髋关节置换术中使用了抗菌切口单。非分层和分层分析均显示,与不使用切口单相比,抗菌切口单显著降低了污染风险(优势比=0.54,p<0.0001)。含碘的切口单,如Ioban,显著降低了全关节置换术中的污染风险。(《外科骨科进展杂志》33(4):206 - 211, 2024)

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