Meta AnalysisID 7192
抗菌敷料用于闭合性切口手术伤口：一项系统评价与Meta分析
CRD42023410085
Do antimicrobial dressings confer any advantage over standard dressings following surgery in traumatic wounds in terms of surgical site infection? PICO: Population: patients of any age undergoing surgery which has result
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Record Fields
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- Meta Analysis Id
- 7192
- Evidence Id
- 15750
- Core Evidence Id
- 15750
- Source Meta Analysis Id
- 7179
- Herb2 Meta Analysis Id
- HBMA007179
- Crd Id
- CRD42023410085
- Title
- Antimicrobial dressing in closed incisional surgical wounds: a systematic review and meta-analysis
- Review Question
- Do antimicrobial dressings confer any advantage over standard dressings following surgery in traumatic wounds in terms of surgical site infection? PICO: Population: patients of any age undergoing surgery which has resulted in a closed incisional surgical wound Intervention: antimicrobial dressing (any recommended by NICE/BNF including: honey dressings, iodine dressings, bactigras, aquacel ag, inadine, iodine soaked gauze, povidone-iodine fabric, alginate, low adherence silver, foam dressing, hydrocolloid, chlorhexidine impregnated dressing/gauze, soft polymer, silver with charcoal Comparator: standard post operative dressing Outcomes: SSI at 30 days, SSI at 90 days, health-related quality of life, cost-effectiveness analyses
- Study Type Included
- Included: randomised control trial, quasi-randomised control trials, observational studies: cohort, case control, case series Excluded studies: case reports, letters, literature reviews, systematic reviews, animal studies, cadaveric studies, laboratory studies
- Condition Being Studied
- Primary intention healing is when wound edges are brought and kept together e.g. by sutures. A surgical site infection (SSI) is a recognised post-operative complication. Infection in the surgical wound may prevent healing, cause wound edge separation, or abscess formation in deeper tissues. Surgical wounds can be classified into clean, clean-contaminated, contaminated, and dirty/infected. There is currently no classification system for open traumatic wounds beyond the general causes and structural involvement i.e. open fracture wound and other open traumatic wounds limited to soft tissue damage. The studies we will be looking at, will be investigating non-infected contaminated and dirty wounds, as all open traumatic wounds fall into these two categories. According to the centre for disease control (CDC), SSIs can broadly be categorised into three groups: Superficial incisional SSI (Superficial Incisional Primary and Superficial Incisional Secondary), Deep incisional SSI (Deep Incisional Primary and Deep Incisional Secondary) and organ/space SSI. Post-operative dressings can be split into non-antimicrobial (standard) dressing, specialised and antimicrobial. Antimicrobial dressings can be applied to a wound to reduce the level of a bacteria at the wound surface. The amount of exudate and presence of infection, determines the appropriate antimicrobial dressing. We will review efficacy and cost-effectiveness of antimicrobial dressings in preventing SSIs.
- Participant
- Inclusion: Patients who have undergone surgery and primary closure has occurred. We include elective and trauma surgeries. Both adult and paediatric cohorts will be eligible for inclusion. There will be no restrictions on study sample size, year of publication or location of study. Exclusion: secondary intentional healing, non-human studies, surgical procedures to treat infections, primary infected wounds (class 3 and 4 wounds), immune system disorders, chemo-, radio- and immunosuppressive therapy within 30 days prior to study enrolment, systemic corticosteroids (intake > 10 mg/day), text not written in English, not a full text article
- Animal
- Human Disease Modelled
- Intervention
- All studies that assess the outcomes of patients who have had Intervention is any antimicrobial dressing. The antimicrobial dressings to be reviewed are: honey dressings (including honey-based topical application and sheet dressing), Iodine dressings (povidone-iodine fabric dressing, iodine dressing), chlorhexidine gauze dressing, silver dressings (alginate, foam, hydrocolloid, low adherence, soft polymer, with charcoal).
- Comparator Control
- Intervention is compared with standard clinical procedure/non antimicrobial dressing
- Main Outcome
- • SSI at 30 days • SSI at 90 days • Health-related quality of life (HRQOL) Measures of effect Descriptive quantitative analysis Risk of infection usually reported as a risk (%) descriptively, defined by the proportion of participants that develop SSIcompared to those that do not. If possible, statistical models for risk could be used to determine relative risks, odds ratios, relative risks and number needed to treat.
- Outcome Measure
- Additional Outcome
- • SSI 90 days • PROMs for wound healing (e.g. Wound-Q, Bluebelle WHQ) • HRQoL • Measures of cost-effectiveness Measures of effect Patient reported outcome measures (PROMs) generate continuous outcome data which is often described using mean(SD) or median/range. Risk of re-admission, chronic infection is usually reported as a risk (%) descriptively, defined by the proportion of participants that develop an infection compared to those that do not. Statistical models for risk are then used to determine relative risks, odds ratios, relative risks and number needed to treat (especially when an intervention to moderate SSI has been studied).
- Study Method
- Meta-analysis, Systematic review
- Keyword
- Alginates; Anti-Infective Agents; Bandages; Carboxymethylcellulose Sodium; Charcoal; Chlorhexidine; Colloids; Honey; Humans; Infant; Iodine; Polymers; Povidone-Iodine; Quality of Life; Silver; Surgical Wound; Surgical Wound Infection
- Contact
- Soma Farag [email protected]
- Organisational Affiliation
- Oxford University Hospitals NHS Foundation Trust
- Funding Source
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences
- Other Selection Criteria
- Final Publication
- Same Topic Review
- Published Protocol
- Review Type
- Language
- English
- Country
- England
- Review Stage
- Review Ongoing
- First Submission Date
- 2023-06-06
- Registration Date
- 2023-06-07
- Anticipated Start Date
- 2023-05-31
- Anticipated Completion Date
- 2023-10-31
- Title Cn
- 抗菌敷料用于闭合性切口手术伤口：一项系统评价与Meta分析
- Title En
- Antimicrobial dressing in closed incisional surgical wounds: a systematic review and meta-analysis
- Bilingual Status
- complete