TY - JOUR
T1 - Preoperative chlorhexidine reduces the incidence of surgical site infections in total knee and hip arthroplasty
T2 - A systematic review and meta-analysis
AU - Cai, Yuanzhen
AU - Xu, Ke
AU - Hou, Weikun
AU - Yang, Zhi
AU - Xu, Peng
N1 - Publisher Copyright:
© 2017 IJS Publishing Group Ltd
PY - 2017/3/1
Y1 - 2017/3/1
N2 - Objective This meta-analysis aims to assess the incidences of surgical site infection of patients who applied preadmission chlorhexidine skin preparation, versus those who applied the traditional skin preparation before undergoing total knee and hip arthroplasty. Methods A systematic search is carried out through Medline (1966–2016.11), PubMed (1966–2016.11), Embase (1980–2016.11), ScienceDirect (1985–2016.11) and the Cochrane Library. Only high quality studies are identified. Meta-analysis is conducted with the use of Stata 11.0 software. Results One RCT and five retrospective studies, published between 2010 and 2016, are included in the present meta-analysis. The present meta-analysis indicates that there are significant differences in surgical site infection rate (RD = −0.02, 95% CI: −0.02 to −0.01, P < 0.00001), revision surgery rate (RD = −0.01, 95% CI: −0.01 to −0.01, P < 0.00001) and length of stay (MD = −0.29, 95% CI: −0.48 to −0.11, P = 0.002) between groups. Conclusion Preoperative chlorhexidine skin preparation appears to reduce the risk of infection, the incidence of revision surgery, and the length of stay for patients undergoing total knee and hip arthroplasty. No adverse effects, such as DVT or PE, appear to be related to chlorhexidine preparation. Due to the limited quality of the evidence currently available, high quality RCTs with better study designs, larger sample sizes and longer follow-ups are needed.
AB - Objective This meta-analysis aims to assess the incidences of surgical site infection of patients who applied preadmission chlorhexidine skin preparation, versus those who applied the traditional skin preparation before undergoing total knee and hip arthroplasty. Methods A systematic search is carried out through Medline (1966–2016.11), PubMed (1966–2016.11), Embase (1980–2016.11), ScienceDirect (1985–2016.11) and the Cochrane Library. Only high quality studies are identified. Meta-analysis is conducted with the use of Stata 11.0 software. Results One RCT and five retrospective studies, published between 2010 and 2016, are included in the present meta-analysis. The present meta-analysis indicates that there are significant differences in surgical site infection rate (RD = −0.02, 95% CI: −0.02 to −0.01, P < 0.00001), revision surgery rate (RD = −0.01, 95% CI: −0.01 to −0.01, P < 0.00001) and length of stay (MD = −0.29, 95% CI: −0.48 to −0.11, P = 0.002) between groups. Conclusion Preoperative chlorhexidine skin preparation appears to reduce the risk of infection, the incidence of revision surgery, and the length of stay for patients undergoing total knee and hip arthroplasty. No adverse effects, such as DVT or PE, appear to be related to chlorhexidine preparation. Due to the limited quality of the evidence currently available, high quality RCTs with better study designs, larger sample sizes and longer follow-ups are needed.
KW - Chlorhexidine
KW - Meta-analysis
KW - Surgical site infection
KW - Total hip arthroplasty
KW - Total knee arthroplasty
UR - https://www.scopus.com/pages/publications/85012224715
U2 - 10.1016/j.ijsu.2017.02.004
DO - 10.1016/j.ijsu.2017.02.004
M3 - 文献综述
C2 - 28189811
AN - SCOPUS:85012224715
SN - 1743-9159
VL - 39
SP - 221
EP - 228
JO - International journal of surgery (London, England)
JF - International journal of surgery (London, England)
ER -