Use of Antibacterial Envelopes in Neuromodulation Surgeries With Implantable Device Insertion: A Systematic Review and Meta-Analysis.

IF 3.9 2区 医学 Q1 CLINICAL NEUROLOGY Neurosurgery Pub Date : 2024-11-01 DOI:10.1227/neu.0000000000003242
Helen Michaela de Oliveira, Lucas Mendes Barbosa, Fernanda Valeriano Zamora, Bruna Oliveira de Paula, Guilherme Oliveira de Paula, Julie G Pilitsis, Pablo Ramon Fruett da Costa
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Abstract

Background and objectives: Neuromodulation is an advanced therapeutic intervention for managing various neurological, psychiatric, and functional disorders. However, a significant challenge is the risk of infections at the device implantation site. Previous studies have shown that antibacterial envelopes used in cardiovascular surgeries significantly reduce infection risk. It is postulated that similar benefits could occur in neurosurgeries involving implant insertion, but the literature lacks studies analyzing this efficacy. This study aimed to evaluate the effectiveness of antibacterial envelopes in reducing infection rates associated with neuromodulation implants.

Methods: We systematically searched PubMed, Embase, and the Cochrane Central Register of Controlled Trials databases up to August 2024 for clinical trials comparing the use of antibacterial impregnated envelopes in patients undergoing neuromodulation-related implant insertion. This study followed Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. Statistical analyses were performed using R version 4.3.2. Risk of bias was assessed using the Risk Of Bias In Nonrandomized Studies-of Interventions tool, and the quality of evidence was evaluated using the Grading of Recommendations Assessment, Development and Evaluation assessment. The study was registered in Prospective Register of Systematic Reviews.

Results: Four studies, comprising 1242 patients, were included, of whom 704 (56.7%) received antibacterial envelopes. The pooled analysis showed that the odds of infection were 77% lower in patients using the antibacterial envelope compared with the control group (odds ratios = 0.23; 95% CI = 0.10-0.51; P < .001; I2 = 2%).

Conclusion: The use of an antibacterial envelope significantly reduces the odds of infection in patients undergoing neuromodulation-related implant insertion by 77%. These findings underscore the potential of antibacterial envelopes to improve postoperative outcomes.

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在植入可植入设备的神经调控手术中使用抗菌包膜:系统回顾与元分析》。
背景和目的:神经调控是一种先进的治疗干预手段,可用于治疗各种神经、精神和功能性疾病。然而,一个重大挑战是装置植入部位的感染风险。先前的研究表明,心血管手术中使用的抗菌包膜可显著降低感染风险。据推测,神经外科手术中的植入物植入也会产生类似的益处,但文献中缺乏对这种功效的分析研究。本研究旨在评估抗菌包膜在降低神经调控植入物相关感染率方面的效果:我们系统地检索了 PubMed、Embase 和 Cochrane Central Register of Controlled Trials 数据库(截止到 2024 年 8 月)中关于比较在接受神经调控相关植入物的患者中使用抗菌浸渍包膜的临床试验。本研究遵循《系统综述和元分析首选报告项目》指南。统计分析使用 R 4.3.2 版本进行。使用 "非随机干预研究中的偏倚风险 "工具对偏倚风险进行了评估,并使用 "建议评估、开发和评价分级 "对证据质量进行了评估。该研究已在前瞻性系统综述注册中心注册:结果:共纳入了四项研究,包括 1242 名患者,其中 704 人(56.7%)接受了抗菌包膜治疗。汇总分析显示,与对照组相比,使用抗菌包膜的患者感染几率降低了 77%(几率比 = 0.23;95% CI = 0.10-0.51;P < .001;I2 = 2%):结论:使用抗菌包膜可将接受神经调控相关植入物插入手术的患者的感染几率大幅降低 77%。这些发现强调了抗菌包膜改善术后效果的潜力。
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来源期刊
Neurosurgery
Neurosurgery 医学-临床神经学
CiteScore
8.20
自引率
6.20%
发文量
898
审稿时长
2-4 weeks
期刊介绍: Neurosurgery, the official journal of the Congress of Neurological Surgeons, publishes research on clinical and experimental neurosurgery covering the very latest developments in science, technology, and medicine. For professionals aware of the rapid pace of developments in the field, this journal is nothing short of indispensable as the most complete window on the contemporary field of neurosurgery. Neurosurgery is the fastest-growing journal in the field, with a worldwide reputation for reliable coverage delivered with a fresh and dynamic outlook.
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