手和手腕:抗微生物和感染 (HAWAII) 试验
Justin Conrad Rosen Wormald1, Jeremy Rodrigues2,3, Rinah Bheekharry3
1Oxford Trauma and Emergency Care, Kadoorie Centre, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK.
在手部创伤手术后,抗微生物可能是可行的预防手术部位感染 (SSI). 需要进一步的研究来改善最终试验的参与者保留率.
科学领域:
- 整形外科手术 整形外科手术
- 预防传染病 预防传染病
- 临床试验设计 临床试验设计
背景情况:
- 手部创伤每年影响数百万人,需要进行大量手术.
- 手术部位感染 (SSI) 是手部创伤手术的一个重要并发症.
- 抗微生物线在减少SSI方面显示出希望,但在手部创伤方面缺乏证据.
研究的目的:
- 评估最终随机对照试验 (RCT) 的可行性,用于手部创伤中的抗微生物.
- 评估在接受抗微生物药物和标准接的患者中SSI的发生率.
- 探索二次结果,包括手部功能,生活质量和就业状况.
主要方法:
- 一个多中心可行性RCT比较抗微生物和标准.
- 接受手部创伤手术的116名成年参与者被随机分配为1:1.
- 使用了对参与者的失明和按年龄和受伤类型的分层.
主要成果:
- 招聘和资格率很高,但参与者保留率在6个月 (45.1%) 低.
- 手术部位感染 (SSI) 发生率在干预组和对照组均超过20%.
- 手部功能最初出现恶化,随后恢复到接近受伤前的水平.
结论:
- 手部创伤手术后SSI的风险是相当大的.
- 对手部创伤的抗微生物进行调查的最终RCT是可行的,这取决于改善参与者保留.
- 目前的数据表明,抗微生物可能不会显著减少这一群体的SSI,这需要进一步调查.
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