手术部位感染预防:我们学到了什么,我们在取得进展吗?
Courtney Ierano1,2, Lisa Hall2,3, Rod James1,2
1National Centre for Antimicrobial Stewardship (NCAS), Department of Infectious Diseases, University of Melbourne.
Current opinion in infectious diseases
|September 27, 2023
概括
手术抗微生物预防 (SAP) 准则正在发展. 新证据支持口服手术前的SAP用于结直肠外科手术,但建议不要用于跨关节前列腺活检,突出显示正在进行的研究需求.
科学领域:
- 传染性疾病 传染性疾病
- 在外科手术实践中.
- 基于证据的医学基于证据的医学.
背景情况:
- 手术部位感染 (SSIs) 仍然是医疗保健中的一个重大问题.
- 优化手术抗微生物预防 (SAP) 对于预防SSI至关重要.
- 目前关于最佳SAP方案的证据显示,知识缺口持续存在.
研究的目的:
- 审查目前关于手术抗微生物预防 (SAP) 预防手术部位感染 (SSI) 的证据.
- 在SAP实践中确定共识和持续辩论的领域.
- 突出在SAP试验中需要改进的研究方法.
主要方法:
- 系统审查最近的随机对照试验 (RCT) 和关于SAP的现有文献.
- 分析研究设计,研究结果和SAP干预措施的临床相关性.
- 确定有争议的问题和需要进一步调查的领域.
主要成果:
- 在结直肠外科手术中支持口服手术前的SAP;在跨前列腺活检中不建议使用SAP.
- 基于培养的SAP显示出对经验使用的承诺,用于跨直肠前列腺活检.
- 关于切口术的局部抗微生物药物,线切口术的SAP以及腹腔镜胆囊切口术的辩论仍在继续.
结论:
- SAP证据正在不断发展,针对某些程序出现了具体的建议.
- 需要进一步的高质量,强大的RCT来解决剩余的临床问题.
- 改善试验设计和专注于临床相关结果对于推进SAP实践至关重要.
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