在下肢外周动脉重建中预防感染
Rebeca M Correia1, Luis Cu Nakano1,2, Vladimir Vasconcelos1,2
1Department of Surgery, Division of Vascular and Endovascular Surgery, Universidade Federal de São Paulo, São Paulo, Brazil.
The Cochrane database of systematic reviews
|October 29, 2025
概括
预防性抗生素可以减少外周动脉重建中的手术部位感染 (SSIs),但证据质量较低. 没有特定的抗生素或持续时间显示优越性,负压伤口治疗对减少SSI的证据有限.
科学领域:
- 血管外科 血管外科
- 预防传染病 预防传染病
- 基于证据的医学基于证据的医学.
背景情况:
- 周围动脉疾病 (PAD) 需要动脉重建,这是一种易受移植和手术部位感染 (SSI) 的手术.
- 由于这些感染对全球医疗保健产生重大影响,预防这些感染至关重要.
- 评估预防策略的有效性对于改善患者治疗结果至关重要.
研究的目的:
- 系统地评估药理和非药理干预措施,以预防下肢外围动脉重建中的感染.
- 评估抗微生物疗法,抗毒剂和伤口管理策略.
主要方法:
- 在多个数据库和临床试验注册表中进行了全面的搜索,直到2024年8月.
- 包括随机对照试验 (RCT) 和评估感染预防干预措施的准RCT.
- 使用Cochrane方法和GRADE方法评估偏见风险和证据确定性.
主要成果:
- 预防性抗生素显示可能减少移植感染和SSI率 (低确定性证据).
- 在短期和长期抗生素预防之间或不同类型的全身抗生素之间没有发现显著差异.
- 封闭切口负压疗法可能会降低SSI率 (非常低的确定性证据),其他结果的差异很小.
结论:
- 预防性抗生素可能会降低下肢动脉重建后的SSI,尽管证据的确定性很低.
- 目前的证据不支持特定抗生素的优越性或预防的延长时间 (>24小时).
- 封闭切口负压治疗显示出减少SSI的潜力,但由于证据的确定性非常低,需要进一步调查. 由于事件数据有限,建议谨慎使用.
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