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葡萄糖酸奥来尼定与传统防腐剂用于胃肠外科手术部位感染的比较:一项荟萃分析。

Comparison between olanexidine gluconate and conventional antiseptics for surgical site infection in gastroenterological surgery: A meta-analysis.

作者信息

Matsuda Akihisa, Yamada Takeshi, Uehara Kay, Yamagishi Aya, Yoshida Hiroshi

机构信息

Department of Gastroenterological Surgery Nippon Medical School Tokyo Japan.

Department of Surgery Nippon Medical School Chiba Hokusoh Hospital Chiba Japan.

出版信息

Ann Gastroenterol Surg. 2025 Mar 31;9(5):883-893. doi: 10.1002/ags3.70014. eCollection 2025 Sep.

Abstract

AIM

To compare the preventative effect of the new antiseptic olanexidine gluconate (OLG) with conventional antiseptics on surgical site infections (SSIs) in gastroenterological surgery.

METHODS

A comprehensive electronic literature search was conducted through November 2024 to identify studies comparing the occurrence of SSIs between OLG and conventional antiseptics (Conv), including povidone-iodine (PI) or chlorhexidine gluconate (CHG), for incisional site disinfection. The primary outcomes were the occurrence of overall SSI and incisional SSI (including superficial and deep incisional SSI). A meta-analysis was performed using random-effects models to calculate odds ratios (ORs) with 95% confidence intervals (CIs).

RESULTS

Nine studies involving 7807 patients (OLG,  = 3491; Conv,  = 4316) were included. The overall SSI rates were 7.8% in the OLG group and 11.1% in the Conv group. OLG significantly reduced overall SSIs (OR: 0.65, 95% CI: 0.53-0.81,  < 0.001) without statistical heterogeneity. OLG also significantly reduced incisional SSIs (4.3% vs. 6.6%) (OR: 0.63, 95% CI: 0.49-0.81,  < 0.001) without statistical heterogeneity.

CONCLUSIONS

To our knowledge, this is the first meta-analysis with a sufficient sample size to investigate the effect of OLG compared with other antiseptics, demonstrating that OLG significantly reduces overall SSIs and incisional SSIs in gastroenterological surgery without increasing adverse skin reactions. These findings may enhance SSI management for patients undergoing various types of surgeries by introducing new preventative strategies and potentially lowering SSI-related healthcare costs.

摘要

目的

比较新型抗菌剂葡萄糖酸奥来沙星(OLG)与传统抗菌剂对胃肠外科手术部位感染(SSI)的预防效果。

方法

通过检索截至2024年11月的综合电子文献,以确定比较OLG与传统抗菌剂(Conv)(包括聚维酮碘(PI)或葡萄糖酸氯己定(CHG))用于切口部位消毒时SSI发生率的研究。主要结局为总体SSI和切口SSI(包括浅表和深部切口SSI)的发生率。采用随机效应模型进行荟萃分析,以计算具有95%置信区间(CI)的比值比(OR)。

结果

纳入9项研究,共7807例患者(OLG组3491例;Conv组4316例)。OLG组总体SSI发生率为7.8%,Conv组为11.1%。OLG显著降低了总体SSI(OR:0.65,95%CI:0.53 - 0.81,P < 0.001),且无统计学异质性。OLG还显著降低了切口SSI(4.3%对6.6%)(OR:0.63,95%CI:0.49 - 0.81,P < 0.001),同样无统计学异质性。

结论

据我们所知,这是第一项具有足够样本量来研究OLG与其他抗菌剂效果比较的荟萃分析,表明OLG在胃肠外科手术中显著降低了总体SSI和切口SSI,且未增加皮肤不良反应。这些发现可能通过引入新的预防策略并潜在降低与SSI相关的医疗成本,加强对接受各类手术患者的SSI管理。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/89c8/12414585/577ea9fbf809/AGS3-9-883-g004.jpg

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