在接受心脏手术的成年人中,预防手术部位感染的干预措施
1, Luke J Rogers2, Ricky Vaja3,4
1Leicester Clinical Trials Unit, University of Leicester, Glenfield Hospital, Leicester, UK.
The Cochrane database of systematic reviews
|December 2, 2024
概括
手术部位感染 (SSI) 在成人心脏手术后很常见. 对于脱殖民化和严格的葡萄糖控制等干预措施的证据的确定性低至非常低,这凸显了对标准化报告和进一步研究的需要.
科学领域:
- 心血管外科心血管外科
- 传染性疾病 传染性疾病
- 基于证据的医学基于证据的医学.
背景情况:
- 手术部位感染 (SSI) 是手术后在医院获得的常见感染,死亡率和发病率很高.
- 成人心脏外科手术由于SSI造成了相当大的成本,在英国每年估计为3000万英.
- 现有的SSI预防指南缺乏针对成人心脏手术的特异性,尽管在这个人群中存在普遍的风险因素.
研究的目的:
- 评估术前,术后和术后干预措施在成人心脏手术中预防SSI的临床有效性.
- 评估SSI预防干预和护理包对患者发病率,死亡率和资源利用的影响.
主要方法:
- 进行了随机对照试验 (RCT) 的系统审查和元分析.
- 在Cochrane CENTRAL,MEDLINE和Embase上进行了搜索,直到2021年5月,包括临床试验注册表.
- 包括的研究评估了减少成人心脏手术患者SSI的干预措施,结果包括SSI,死亡率,再手术,住院,再入院,成本和生活质量.
主要成果:
- 涉及51854名参与者的1118项研究确定了22项干预措施. 证据质量主要是由于异质性而低至非常低.
- 解殖表明深度SSI (高确定性) 的减少,但对总SSI和死亡率的影响不确定.
- 严格的血糖控制表明SSI和死亡率的潜在降低 (确定性非常低),而负压伤口治疗对总SSI (确定性非常低) 显示了不确定的益处. 局部 Gentamicin 证明了 SSI (低确定性) 的潜在降低.
结论:
- 本综述提供了在成人心脏手术中减少SSI的干预措施的全面概述,确定了整个外科手术期间的21项干预措施.
- 证据基础的确定性低至非常低,主要是由于干预实施和SSI定义的异质性.
- 显著的知识差距需要未来的研究,强调需要标准化的SSI结果报告来改善临床实践和患者的结果.
相关概念视频
Healthcare Associated Infections II: Preventive Measures
2.5K
Essential infection prevention measures are based on the knowledge of the infection chain, the modes of transmission in healthcare settings, and the use of the best practices in all healthcare settings. Compulsory public reporting of healthcare-associated infection rates is needed to allow individuals and the community to make informed choices regarding selecting a healthcare facility.
The best practices for preventing healthcare-associated infections include hand hygiene, patient risk...
The best practices for preventing healthcare-associated infections include hand hygiene, patient risk...
2.5K
Endocarditis III: Medical Management
1
Infective endocarditis management involves a multifaceted approach encompassing infection prevention, lifestyle modifications, pharmacological therapy, and surgical management.Infection Prevention:Hand Hygiene: Thorough handwashing is crucial to prevent the spread of infection. Hand hygiene should be performed regularly, especially before and after using the restroom.Oral Hygiene: Good oral hygiene is essential. It includes brushing teeth immediately after waking up and before bed, flossing...
1
Hand hygiene
3.1K
Asepsis is the practice of preventing or breaking the chain of infection. The nurse employs aseptic techniques to prevent the spread of microorganisms and reduce the risk of diseases. Hand hygiene is the cornerstone of aseptic techniques and is classified into medical and surgical asepsis. Medical asepsis includes hand hygiene and the use of gloves. Surgical asepsis, or the sterile technique, refers to practices that render and keep objects and areas free of microorganisms.
Hand washing...
Hand washing...
3.1K
Standard Precaution
1.9K
Standard precautions are the minimum infection control safeguards used while caring for all patients, irrespective of their disease condition. They help prevent the spread of common infectious microorganisms to healthcare workers, patients, and visitors in all healthcare settings.
Hand hygiene is the most crucial means to prevent the transmission of disease. Employers are legally required to provide their workers with personal protective equipment (PPE) to minimize exposure or contact with...
Hand hygiene is the most crucial means to prevent the transmission of disease. Employers are legally required to provide their workers with personal protective equipment (PPE) to minimize exposure or contact with...
1.9K
Endocarditis IV: Nursing Management
1
Infective endocarditis (IE) is a chronic infection of the heart's endocardium, primarily affecting the heart valves. A detailed nursing assessment for a patient with IE involves collecting subjective and objective data to ensure an accurate diagnosis and timely intervention.Subjective DataThe nurse gathers information about the patient's symptoms and complaints during the subjective assessment. Patients with infective endocarditis often report non-specific symptoms that can mimic other...
1
Asepsis
2.1K
The condition of being free from disease-causing living pathogens is asepsis. Aseptic techniques include a set of standard practices to achieve asepsis. An example is the regular environmental cleaning of all parts of the healthcare facility and hand hygiene at home before preparing or eating food. Medical and surgical asepsis in healthcare practice protects patients from harmful pathogens, minimizes the risk of contamination of susceptible sites, and reduces the risk of infection transmission.
2.1K


