{"id":26425,"date":"2024-09-15T04:02:00","date_gmt":"2024-09-14T20:02:00","guid":{"rendered":"http:\/\/csccm.org.cn\/?p=26425"},"modified":"2024-09-16T06:43:47","modified_gmt":"2024-09-15T22:43:47","slug":"jama-surg%e5%8f%91%e8%a1%a8%e8%ae%ba%e6%96%87%ef%bc%9a%e5%88%87%e5%8f%a3%e5%86%b2%e6%b4%97%e4%bb%a5%e9%a2%84%e9%98%b2%e6%89%8b%e6%9c%af%e9%83%a8%e4%bd%8d%e6%84%9f%e6%9f%93","status":"publish","type":"post","link":"https:\/\/csccm.org.cn\/?p=26425","title":{"rendered":"[JAMA Surg\u53d1\u8868\u8bba\u6587]\uff1a\u5207\u53e3\u51b2\u6d17\u4ee5\u9884\u9632\u624b\u672f\u90e8\u4f4d\u611f\u67d3"},"content":{"rendered":"\n

Original Investigation <\/p>\n\n\n\n

April 24, 2024<\/p>\n\n\n\n

Incisional Wound Irrigation for the Prevention of Surgical Site Infection: A Systematic Review and Network Meta-Analysis<\/h1>\n\n\n\n

Hannah Groenen, Nathan Bontekoning, Hasti Jalalzadeh, et al<\/h3>\n\n\n\n

JAMA Surg. <\/em>2024;159(7):792-800. doi:10.1001\/jamasurg.2024.0775<\/h3>\n\n\n\n

<\/a>Key Points<\/p>\n\n\n\n

Question<\/strong>  What are the outcomes of different types of prophylactic intraoperative incisional wound irrigation solutions for the prevention of surgical site infections (SSIs) in all types of surgery?<\/p>\n\n\n\n

Findings<\/strong>  Results of this systematic review and network meta-analysis including 41 randomized clinical trials found high-certainty evidence that wound irrigation with aqueous antiseptic solutions was associated with a significant reduction in SSIs compared with no irrigation and low-certainty evidence that wound irrigation with antibiotic solutions was associated with a significant reduction in SSIs compared with no irrigation.<\/p>\n\n\n\n

Meaning<\/strong>  Incisional wound irrigation with aqueous antiseptic solutions was associated with a reduction in the risk of SSIs; results suggest that the use of antibiotic wound irrigation be avoided due to the inferior certainty of evidence for its outcome and global antimicrobial resistance concerns.<\/a><\/p>\n\n\n\n

Abstract<\/p>\n\n\n\n

Importance<\/strong>  Surgical site infections (SSIs) are common postoperative complications and associated with significant morbidity, mortality, and costs. Prophylactic intraoperative incisional wound irrigation is used to reduce the risk of SSIs, and there is great variation in the type of irrigation solutions and their use.<\/p>\n\n\n\n

Objective<\/strong>  To compare the outcomes of different types of incisional prophylactic intraoperative incisional wound irrigation for the prevention of SSIs in all types of surgery.<\/p>\n\n\n\n

Data Sources<\/strong>  PubMed, Embase, CENTRAL, and CINAHL databases were searched up to June 12, 2023.<\/p>\n\n\n\n

Study Selection<\/strong>  Included in this study were randomized clinical trials (RCTs) comparing incisional prophylactic intraoperative incisional wound irrigation with no irrigation or comparing irrigation using different types of solutions, with SSI as a reported outcome. Studies investigating intracavity lavage were excluded.<\/p>\n\n\n\n

Data Extraction and Synthesis<\/strong>  This systematic review and network meta-analysis is reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis statement. Two reviewers independently extracted the data and assessed the risk of bias within individual RCTs using the Cochrane Risk of Bias 2 tool and the certainty of evidence using the Grading of Recommendations, Assessment, Development, and Evaluation framework. A frequentist network meta-analysis was conducted, and relative risks (RRs) with corresponding 95% CIs were reported.<\/p>\n\n\n\n

Main Outcome and Measure<\/strong>  The primary study outcome was SSI.<\/p>\n\n\n\n

Results<\/strong>\u00a0\u00a0A total of 1587 articles were identified, of which 41 RCTs were included in the systematic review, with 17\u202f188 patients reporting 1328 SSIs, resulting in an overall incidence of 7.7%. Compared with no irrigation, antiseptic solutions (RR, 0.60; 95% CI, 0.44-0.81; high level of certainty) and antibiotic solutions (RR, 0.46; 95% CI, 0.29-0.73; low level of certainty) were associated with a beneficial reduction in SSIs. Saline irrigation showed no statistically significant difference compared with no irrigation (RR, 0.83; 95% CI, 0.63-1.09; moderate level of certainty).<\/p>\n\n\n\n

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Conclusions and Relevance<\/strong>  This systematic review and network meta-analysis found high-certainty evidence that prophylactic intraoperative incisional wound irrigation with antiseptic solutions was associated with a reduction in SSIs. It is suggested that the use of antibiotic wound irrigation be avoided due to the inferior certainty of evidence for its outcome and global antimicrobial resistance concerns.<\/p>\n","protected":false},"excerpt":{"rendered":"

Original Investigation  April 24, 2024 Incisional […]<\/p>\n","protected":false},"author":3,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":[],"categories":[32,23],"tags":[],"_links":{"self":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/26425"}],"collection":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=26425"}],"version-history":[{"count":3,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/26425\/revisions"}],"predecessor-version":[{"id":26727,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/26425\/revisions\/26727"}],"wp:attachment":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=26425"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=26425"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=26425"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}