Wound irrigation and peritoneal lavage with antiseptic/antibiotic solution before wound closure during gastrointestinal surgery: a systematic review and meta-analysis.

IF 1.8 3区医学 Q2 SURGERY BMC Surgery Pub Date : 2025-01-23 DOI:10.1186/s12893-025-02774-3

Motoi Uchino, Koji Tamura, Shinsuke Nomura, Seiichi Shinji, Keita Kouzu, Hiroji Shinkawa, Tomohiro Ishinuki, Toru Mizuguchi, Hiroki Ohge, Seiji Haji, Junzo Shimizu, Yasuhiko Mohri, Chizuru Yamashita, Yuichi Kitagawa, Katsunori Suzuki, Motomu Kobayash, Masahiro Kobayashi, Yuki Hanai, Hiroshi Nobuhara, Hiroki Imaoka, Masahiro Yoshida, Toshihiko Mayumi, Hiroki Ikeuchi

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Abstract

Background: Surgical site infections (SSIs) can affect mortality, morbidity, and medical costs. Although it has recently been reported that washing with antiseptic/antibiotic solution can prevent SSI in clean surgery, the clinical impact in gastrointestinal surgery is still uncertain. Therefore, we performed a systematic review and meta-analysis to evaluate the efficacy of antiseptic/antibiotic solution during wound irrigation or peritoneal lavage in gastroenterological surgery.

Methods: The database search used PubMed, MEDLINE, and Cochrane Library. The following inclusion criteria were set for the systematic review. 1) Studies comparing with or without antiseptic/antibiotic irrigation/lavage during gastrointestinal surgery. 2) Studies that described surgical site infections and adverse events. 3) Studies conducted after 2000.

Results: A total of 8 randomized controlled studies (RCTs) and 3 observational studies were included in this meta-analysis. Three RCTs of wound irrigation with povidone iodine (PVI) solution revealed no significant difference between the PVI and control groups [RR 1.41, 95% CI (0.92 to 2.17): p = 0.69]. Three RCTs of peritoneal lavage with antibiotic solution showed no significant difference between the interventional group and control groups [RR 0.39, 95% CI (0.10 to 1.55): p = 0.18]. Regarding other antiseptic or antibiotic solutions, the number of studies and participants were too small for evaluation.

Conclusion: Wound irrigation and peritoneal lavage with antiseptic/antibiotic solution did not have enough efficacy for preventing SSI during gastroenterological surgery.

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胃肠道手术中伤口关闭前用抗菌/抗生素溶液冲洗和腹腔灌洗：一项系统回顾和荟萃分析。

背景：手术部位感染（ssi）可影响死亡率、发病率和医疗费用。虽然最近有报道称用抗菌/抗生素溶液清洗可以预防清洁手术中的SSI，但在胃肠道手术中的临床影响仍不确定。因此，我们进行了一项系统回顾和荟萃分析，以评估在胃肠外科手术中伤口冲洗或腹膜灌洗时使用抗菌/抗生素溶液的疗效。方法：数据库检索采用PubMed、MEDLINE、Cochrane Library。为系统评价设定了以下纳入标准。1)胃肠手术中使用或不使用消毒/抗生素冲洗/灌洗的比较研究。2)描述手术部位感染和不良事件的研究。3) 2000年以后的研究。结果：本meta分析共纳入8项随机对照研究（RCTs）和3项观察性研究。聚维酮碘（PVI）溶液创面冲洗的3个rct显示PVI组与对照组无显著差异[RR 1.41, 95% CI (0.92 ~ 2.17): p = 0.69]。3个抗生素溶液腹腔灌洗的rct，干预组与对照组比较无显著差异[RR 0.39, 95% CI (0.10 ~ 1.55): p = 0.18]。至于其他防腐剂或抗生素溶液，研究和参与者的数量太少，无法进行评估。结论：抗菌/抗生素溶液冲洗和腹腔灌洗对预防胃肠外科手术中SSI的效果不足。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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