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Frank J. P. Beeres - One of the best experts on this subject based on the ideXlab platform.
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Simple Wound Irrigation in the Postoperative Treatment for Surgically Drained Spontaneous Soft Tissue Abscesses: A Prospective, Randomized Controlled Trial
World journal of surgery, 2020Co-Authors: Florian Oehme, Annika Rühle, Katja Börnert, Reto Babst, Björn-christian Link, Jürg Metzger, S. Hempel, Frank J. P. BeeresAbstract:BACKGROUND Soft tissue abscesses are among the most frequently encountered medical problems treated by different surgeons. Standard therapy remains incision and drainage with sterile saline Irrigation during postoperative Wound healing period. Aim of this prospective randomized controlled trial was to compare sterile Irrigation versus nonsterile Irrigation. STUDY DESIGN A single center randomized controlled trial was performed to investigate postoperative Wound Irrigation. The control group used sterile Irrigation, and the intervention group used nonsterile Irrigation. Primary endpoints were reinfection and reintervention rates, assessed during follow-up controls for up to 2 years. Secondary endpoints were the duration of Wound healing, inability to work, pain and quality of life. RESULTS Between 04/2016 and 05/2017, 118 patients were randomized into two groups, with 61 allocated to the control- and 57 to the intervention group. Reinfection occurred in a total of 4 cases (6.6%) in the sterile protocol and 4 (7%) in the nonsterile protocol. Quality of life and pain values were comparable during the Wound healing period, and patients treated according to the nonsterile Irrigation protocol used significantly fewer Wound care service teams. Despite equal Wound persistence rates, a substantially shorter amount of time off from work was reported in the nonsterile protocol group (p value 0.086). CONCLUSION This prospective, randomized trial indicates that a nonsterile Irrigation protocol for patients operated on for soft tissue abscesses is not inferior to the standard sterile protocol. Moreover, a nonsterile Irrigation protocol leads to a shorter period of inability to work with comparable pain and quality of life scores during the Wound healing period.
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Simple Wound Irrigation in the Postoperative Treatment for Surgically Drained Spontaneous Soft Tissue Abscesses: Study Protocol for a Prospective, Single-Blinded, Randomized Controlled Trial
JMIR research protocols, 2017Co-Authors: Annika Rühle, Florian Oehme, Katja Börnert, Lana Fourie, Reto Babst, Björn-christian Link, Jürg Metzger, Frank J. P. BeeresAbstract:Background: Skin abscesses are a frequent encountered health care problem and lead to a significant source of morbidity. They consequently have an essential impact on the quality of life and work. To date, the type of aftercare for surgically drained abscesses remains under debate. This leads to undesirable practice variations. Many clinical standard protocols include sterile Wound dressings twice a day by a home-care service to reduce the chance of a recurrent Wound infection. It is unknown, however, whether reinfection rates are comparable to adequate Wound Irrigation with a nonsterile solution performed by the patient. Our hypothesis is that simple Wound Irrigation with nonsterile water for postoperative Wound care after an abscess is surgically drained is feasible. We assume that in terms of reinfection and reintervention rates unsterile Wound Irrigation is equal to sterile Wound Irrigation. Objective: The primary aim of this study is therefore to investigate if there is a need for sterile Wound Irrigation after surgically drained spontaneous skin abscesses. Methods: In a prospective, randomized controlled, single-blinded, single-center trial based on a noninferiority design, we will enroll 128 patients randomized to either the control or the intervention group. The control group will be treated according to our current, standard protocol in which all patients receive a sterile Wound Irrigation performed by a home-care service twice a day. Patients randomized to the intervention group will be treated with a nonsterile Wound Irrigation (shower) twice a day. All patients will have a routine clinical control visit after 1, 3, 6, and 12 weeks in the outpatient clinic. Primary outcome is the reinfection and reoperation rate due to insufficient Wound healing diagnosed either at the outpatient control visit or during general practitioner visits. Secondary outcome measures include a Short Form Health Survey, Visual Analog Scale, Patient and Observer Scar Assessment Scale, Vancouver Scar Scale, and the EurolQol 5-Dimension Questionnaire. Those questionnaires will be completed at the outpatient control visits. Results: The trial was started in June 2016 and enrolled 50 patients by article publication. Regarding the adherence to our protocol, we found 10% of loss to follow-up until now. Only 2 patients needed reoperation and only 1 patient needed a change of treatment (antiseptic therapy). Most patients are happy with their randomized treatment but as expected some patients in the sterile group complained about timing problems with their working hours and home-care service appointments. Most patients in the nonsterile group are satisfied being able to take care of their Wounds independently although some patients still depend on the home-care service for the Wound dressing. We are hoping to have enrolled enough patients by summer 2017. The follow-up will take until autumn 2017, and study results are expected to be published by the end of 2017. This trial is solely supported by the cantonal hospital of Lucerne. Conclusions: Nonsterile Wound Irrigation is more likely to be carried out independently by the patient than sterile Wound Irrigation. Therefore, if nonsterile Wound care shows comparable results in terms of reinfection and reintervention rates, patient independence in the aftercare of surgically drained abscesses will increase, patients can return to work earlier, and health care costs can be reduced. In a preliminary, conservative estimation of health care costs, an annual savings of 300,000 CHF will be achieved in our hospital. Trial Registration: German Clinical Trials Register DRKS00010418; https://drks-neu.uniklinik-freiburg.de/ drks_web/navigate.do?navigationId=trial.HTMLT6(5):e77]
Julian-dario Rembe - One of the best experts on this subject based on the ideXlab platform.
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The role of saline Irrigation prior to Wound closure in the reduction of surgical site infection: a systematic review and meta-analysis.
Patient safety in surgery, 2020Co-Authors: Peter C. Ambe, Julian-dario Rembe, Tanja Rombey, Hubert Zirngibl, Johannes Dörner, Dawid PieperAbstract:Background Surgical site infection (SSI) describes an infectious complication of surgical Wounds. Although SSI is thought to be preventable, it still represents a major cause of morbidity and substantial economic burden on the health system. Wound Irrigation (WI) might reduce the level of bacterial contamination, but current data on its role in reducing or preventing SSI is conflicting. Our aim was to investigate the effectiveness of WI with normal saline prior to Wound closure for the reduction of SSI in patients undergoing abdominal surgery. Methods We conducted a systematic literature search in MEDLINE, EMBASE, and CENTRAL from inception to present, and cross-checked the reference lists of all included primary studies and relevant systematic reviews. (Quasi-) randomized controlled trials (RCTs) investigating the rate of SSI when using normal saline vs. no Irrigation prior to Wound closure following abdominal surgery were included. Primary outcome was the rate of SSI, secondary outcome the mean length of hospital stay (LOS). Results Four RCTs including a total of 1194 patients were included for analysis. All studies compared Wound Irrigation with normal saline with no Wound Irrigation prior to Wound closure. Their risk of bias was moderate. The relative risk of developing a SSI was lower when Wound Irrigation with normal saline was performed prior to Wound closure although the effect was not statistically significant (risk ratio 0.73, 95%-confidence level: 0.37 to 1.43). Similarly, there was no difference in the LOS amongst both intervention arms. Conclusion This systematic review could not identify an advantage for routine Irrigation of abdominal Wounds with normal saline over no Irrigation prior to Wound closure in preventing or reducing the rate of SSI. Systematic review registration PROSPERO registry number CRD42018082287 .
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Antimicrobial Hypochlorous Wound Irrigation Solutions Demonstrate Lower Anti-biofilm Efficacy Against Bacterial Biofilm in a Complex in-vitro Human Plasma Biofilm Model (hpBIOM) Than Common Wound Antimicrobials.
Frontiers in microbiology, 2020Co-Authors: Julian-dario Rembe, Lioba Franziska Huelsboemer, Manuela Besser, Isabell Plattfaut, Ewa K. StuermerAbstract:Biofilms pose a relevant factor for Wound healing impairment in chronic Wounds. With 78% of all chronic Wounds being affected by biofilms, research in this area is of high priority, especially since data for evidence-based selection of appropriate antimicrobials and antiseptics is scarce. Therefore, the objective of this study was to evaluate the anti-biofilm efficacy of commercially available hypochlorous Wound Irrigation solutions compared to established antimicrobials. Using an innovative complex in-vitro human plasma biofilm model (hpBIOM), quantitative reduction of Pseudomonas aeruginosa, Staphylococcus aureus, and Methicillin-resistant S. aureus (MRSA) biofilms by three hypochlorous Irrigation solutions [two
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Anti-biofilm activity of antimicrobial hypochlorous Wound Irrigation solutions compared to common Wound antiseptics and bacterial resilience in an innovative in-vitro human plasma biofilm model (hpBIOM)
2020Co-Authors: Julian-dario Rembe, Lioba Franziska Huelsboemer, Manuela Besser, Ewa K. StuermerAbstract:Abstract Background Biofilms pose a relevant factor for Wound healing impairment in chronic Wounds. With 78% of all chronic Wounds being affected by biofilms, research in this area is of high priority, especially since data for evidence-based selection of appropriate antimicrobials and antiseptics is scarce. Therefore, the objective of this study was to evaluate the anti-biofilm efficacy of commercially available hypochlorous Wound Irrigation solutions compared to established antiseptics. Methods Using an innovative complex in-vitro human plasma biofilm model (hpBIOM), quantitative reduction of P. aeruginosa , S. aureus and MRSA biofilms by three hypochlorous Irrigation solutions (two <0.08% and one 0.2% NaClO) were compared to 0.1% octenidine-dihydrochloride/phenoxyethanol (OCT/PE) and 0.04% polyhexanide (PHMB). Efficacy was compared to a non-challenged planktonic approach as well as with increased substance volume over the prolonged treatment course (up to 72h). Qualitative visualisation of biofilms was performed by scanning electron microscopy (SEM). Results Both tested antiseptics (OCT/PE and PHMB) induced significant biofilm reductions within 72h, whereby OCT/PE in an increased volume even managed complete eradication of P. aeruginosa and MRSA biofilms after 72h. The tested hypochlorous Wound Irrigation solutions however achieved no relevant penetration and eradication of biofilms, despite increased volume and exposure. Only 0.2% NaClO managed a low reduction over prolonged treatment time. Conclusion The results in the here used complex human plasma biofilm model closely mimic the clinical situation of a high challenging environment for antimicrobials to perform in. Under these conditions, the low-dosed hypochlorous Wound Irrigation solutions are significantly less effective than antiseptics and thus unsuitable for biofilm eradication.
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The role of saline Irrigation prior to Wound closure in the reduction of surgical site infection: protocol for a systematic review and meta-analysis.
Systematic reviews, 2018Co-Authors: Dawid Pieper, Julian-dario Rembe, Tanja Rombey, Johannes Doerner, Hubert Zirngibl, Konstantinos Zarras, Peter C. AmbeAbstract:Surgical site infection describes an infectious complication of surgical Wounds. This single complication is thought to occur in close to 20% of surgical cases. This complication has been described in all kinds of surgical procedure including minimally invasive procedures. Wound Irrigation is frequently used as a means of reducing surgical site infection. However, there is lack of solid evidence to support routine Wound Irrigation. The aim of this review is to provide evidence for the efficacy of routine Wound Irrigation with normal saline in preventing surgical site infection. The rate of surgical site infection in cases with and without Wound Irrigation will be analyzed. Systematic literature searches will be conducted to identify all published and unpublished studies. The following databases will be searched for citations from inception to present: MEDLINE (via PubMed), Embase (via Embase), and CENTRAL (via the Cochrane library). The search strategy will be developed by the research team in collaboration with an experienced librarian and checked by a referee according to the Peer Review of Electronic Search Strategies (PRESS) guideline. A draft of the PubMed search strategy could be (Irrigation[tiab] OR “Therapeutic Irrigation”[mesh] OR lavage[tiab]) AND (saline[tiab] OR “Sodium Chloride”[mesh] OR sodium chloride[tiab]) NOT (“Comment” [Publication Type] OR “Letter” [Publication Type] OR “Editorial” [Publication Type]). No time limits will be set. The reference lists of eligible articles will be hand searched. Relevant data will be extracted from eligible studies using a previously designed data extraction sheet. Relative risks will be calculated for binary outcomes and mean differences or standardized mean differences, if necessary, for continuous outcomes. For all measures, 95% confidence levels will be calculated. Both arms would be compared with regard to the rate of surgical site infection within 30 days following surgery. We will report the review using the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) statement. This review aims at investigating the value of routine Wound Irrigation using normal saline in preventing surgical site infection. PROSPERO: CRD42018082287
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The role of saline Irrigation prior to Wound closure in the reduction of surgical site infection: protocol for a systematic review and meta-analysis
BMC, 2018Co-Authors: Dawid Pieper, Julian-dario Rembe, Tanja Rombey, Johannes Doerner, Hubert Zirngibl, Konstantinos Zarras, Peter C. AmbeAbstract:Abstract Background Surgical site infection describes an infectious complication of surgical Wounds. This single complication is thought to occur in close to 20% of surgical cases. This complication has been described in all kinds of surgical procedure including minimally invasive procedures. Wound Irrigation is frequently used as a means of reducing surgical site infection. However, there is lack of solid evidence to support routine Wound Irrigation. The aim of this review is to provide evidence for the efficacy of routine Wound Irrigation with normal saline in preventing surgical site infection. The rate of surgical site infection in cases with and without Wound Irrigation will be analyzed. Methods/design Systematic literature searches will be conducted to identify all published and unpublished studies. The following databases will be searched for citations from inception to present: MEDLINE (via PubMed), Embase (via Embase), and CENTRAL (via the Cochrane library). The search strategy will be developed by the research team in collaboration with an experienced librarian and checked by a referee according to the Peer Review of Electronic Search Strategies (PRESS) guideline. A draft of the PubMed search strategy could be (Irrigation[tiab] OR “Therapeutic Irrigation”[mesh] OR lavage[tiab]) AND (saline[tiab] OR “Sodium Chloride”[mesh] OR sodium chloride[tiab]) NOT (“Comment” [Publication Type] OR “Letter” [Publication Type] OR “Editorial” [Publication Type]). No time limits will be set. The reference lists of eligible articles will be hand searched. Relevant data will be extracted from eligible studies using a previously designed data extraction sheet. Relative risks will be calculated for binary outcomes and mean differences or standardized mean differences, if necessary, for continuous outcomes. For all measures, 95% confidence levels will be calculated. Both arms would be compared with regard to the rate of surgical site infection within 30 days following surgery. We will report the review using the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) statement. Discussion This review aims at investigating the value of routine Wound Irrigation using normal saline in preventing surgical site infection. Systematic review registration PROSPERO: CRD4201808228
Peter C. Ambe - One of the best experts on this subject based on the ideXlab platform.
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The role of saline Irrigation prior to Wound closure in the reduction of surgical site infection: a systematic review and meta-analysis.
Patient safety in surgery, 2020Co-Authors: Peter C. Ambe, Julian-dario Rembe, Tanja Rombey, Hubert Zirngibl, Johannes Dörner, Dawid PieperAbstract:Background Surgical site infection (SSI) describes an infectious complication of surgical Wounds. Although SSI is thought to be preventable, it still represents a major cause of morbidity and substantial economic burden on the health system. Wound Irrigation (WI) might reduce the level of bacterial contamination, but current data on its role in reducing or preventing SSI is conflicting. Our aim was to investigate the effectiveness of WI with normal saline prior to Wound closure for the reduction of SSI in patients undergoing abdominal surgery. Methods We conducted a systematic literature search in MEDLINE, EMBASE, and CENTRAL from inception to present, and cross-checked the reference lists of all included primary studies and relevant systematic reviews. (Quasi-) randomized controlled trials (RCTs) investigating the rate of SSI when using normal saline vs. no Irrigation prior to Wound closure following abdominal surgery were included. Primary outcome was the rate of SSI, secondary outcome the mean length of hospital stay (LOS). Results Four RCTs including a total of 1194 patients were included for analysis. All studies compared Wound Irrigation with normal saline with no Wound Irrigation prior to Wound closure. Their risk of bias was moderate. The relative risk of developing a SSI was lower when Wound Irrigation with normal saline was performed prior to Wound closure although the effect was not statistically significant (risk ratio 0.73, 95%-confidence level: 0.37 to 1.43). Similarly, there was no difference in the LOS amongst both intervention arms. Conclusion This systematic review could not identify an advantage for routine Irrigation of abdominal Wounds with normal saline over no Irrigation prior to Wound closure in preventing or reducing the rate of SSI. Systematic review registration PROSPERO registry number CRD42018082287 .
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The role of saline Irrigation prior to Wound closure in the reduction of surgical site infection: protocol for a systematic review and meta-analysis.
Systematic reviews, 2018Co-Authors: Dawid Pieper, Julian-dario Rembe, Tanja Rombey, Johannes Doerner, Hubert Zirngibl, Konstantinos Zarras, Peter C. AmbeAbstract:Surgical site infection describes an infectious complication of surgical Wounds. This single complication is thought to occur in close to 20% of surgical cases. This complication has been described in all kinds of surgical procedure including minimally invasive procedures. Wound Irrigation is frequently used as a means of reducing surgical site infection. However, there is lack of solid evidence to support routine Wound Irrigation. The aim of this review is to provide evidence for the efficacy of routine Wound Irrigation with normal saline in preventing surgical site infection. The rate of surgical site infection in cases with and without Wound Irrigation will be analyzed. Systematic literature searches will be conducted to identify all published and unpublished studies. The following databases will be searched for citations from inception to present: MEDLINE (via PubMed), Embase (via Embase), and CENTRAL (via the Cochrane library). The search strategy will be developed by the research team in collaboration with an experienced librarian and checked by a referee according to the Peer Review of Electronic Search Strategies (PRESS) guideline. A draft of the PubMed search strategy could be (Irrigation[tiab] OR “Therapeutic Irrigation”[mesh] OR lavage[tiab]) AND (saline[tiab] OR “Sodium Chloride”[mesh] OR sodium chloride[tiab]) NOT (“Comment” [Publication Type] OR “Letter” [Publication Type] OR “Editorial” [Publication Type]). No time limits will be set. The reference lists of eligible articles will be hand searched. Relevant data will be extracted from eligible studies using a previously designed data extraction sheet. Relative risks will be calculated for binary outcomes and mean differences or standardized mean differences, if necessary, for continuous outcomes. For all measures, 95% confidence levels will be calculated. Both arms would be compared with regard to the rate of surgical site infection within 30 days following surgery. We will report the review using the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) statement. This review aims at investigating the value of routine Wound Irrigation using normal saline in preventing surgical site infection. PROSPERO: CRD42018082287
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The role of saline Irrigation prior to Wound closure in the reduction of surgical site infection: protocol for a systematic review and meta-analysis
BMC, 2018Co-Authors: Dawid Pieper, Julian-dario Rembe, Tanja Rombey, Johannes Doerner, Hubert Zirngibl, Konstantinos Zarras, Peter C. AmbeAbstract:Abstract Background Surgical site infection describes an infectious complication of surgical Wounds. This single complication is thought to occur in close to 20% of surgical cases. This complication has been described in all kinds of surgical procedure including minimally invasive procedures. Wound Irrigation is frequently used as a means of reducing surgical site infection. However, there is lack of solid evidence to support routine Wound Irrigation. The aim of this review is to provide evidence for the efficacy of routine Wound Irrigation with normal saline in preventing surgical site infection. The rate of surgical site infection in cases with and without Wound Irrigation will be analyzed. Methods/design Systematic literature searches will be conducted to identify all published and unpublished studies. The following databases will be searched for citations from inception to present: MEDLINE (via PubMed), Embase (via Embase), and CENTRAL (via the Cochrane library). The search strategy will be developed by the research team in collaboration with an experienced librarian and checked by a referee according to the Peer Review of Electronic Search Strategies (PRESS) guideline. A draft of the PubMed search strategy could be (Irrigation[tiab] OR “Therapeutic Irrigation”[mesh] OR lavage[tiab]) AND (saline[tiab] OR “Sodium Chloride”[mesh] OR sodium chloride[tiab]) NOT (“Comment” [Publication Type] OR “Letter” [Publication Type] OR “Editorial” [Publication Type]). No time limits will be set. The reference lists of eligible articles will be hand searched. Relevant data will be extracted from eligible studies using a previously designed data extraction sheet. Relative risks will be calculated for binary outcomes and mean differences or standardized mean differences, if necessary, for continuous outcomes. For all measures, 95% confidence levels will be calculated. Both arms would be compared with regard to the rate of surgical site infection within 30 days following surgery. We will report the review using the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) statement. Discussion This review aims at investigating the value of routine Wound Irrigation using normal saline in preventing surgical site infection. Systematic review registration PROSPERO: CRD4201808228
Dawid Pieper - One of the best experts on this subject based on the ideXlab platform.
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The role of saline Irrigation prior to Wound closure in the reduction of surgical site infection: a systematic review and meta-analysis.
Patient safety in surgery, 2020Co-Authors: Peter C. Ambe, Julian-dario Rembe, Tanja Rombey, Hubert Zirngibl, Johannes Dörner, Dawid PieperAbstract:Background Surgical site infection (SSI) describes an infectious complication of surgical Wounds. Although SSI is thought to be preventable, it still represents a major cause of morbidity and substantial economic burden on the health system. Wound Irrigation (WI) might reduce the level of bacterial contamination, but current data on its role in reducing or preventing SSI is conflicting. Our aim was to investigate the effectiveness of WI with normal saline prior to Wound closure for the reduction of SSI in patients undergoing abdominal surgery. Methods We conducted a systematic literature search in MEDLINE, EMBASE, and CENTRAL from inception to present, and cross-checked the reference lists of all included primary studies and relevant systematic reviews. (Quasi-) randomized controlled trials (RCTs) investigating the rate of SSI when using normal saline vs. no Irrigation prior to Wound closure following abdominal surgery were included. Primary outcome was the rate of SSI, secondary outcome the mean length of hospital stay (LOS). Results Four RCTs including a total of 1194 patients were included for analysis. All studies compared Wound Irrigation with normal saline with no Wound Irrigation prior to Wound closure. Their risk of bias was moderate. The relative risk of developing a SSI was lower when Wound Irrigation with normal saline was performed prior to Wound closure although the effect was not statistically significant (risk ratio 0.73, 95%-confidence level: 0.37 to 1.43). Similarly, there was no difference in the LOS amongst both intervention arms. Conclusion This systematic review could not identify an advantage for routine Irrigation of abdominal Wounds with normal saline over no Irrigation prior to Wound closure in preventing or reducing the rate of SSI. Systematic review registration PROSPERO registry number CRD42018082287 .
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The role of saline Irrigation prior to Wound closure in the reduction of surgical site infection: protocol for a systematic review and meta-analysis.
Systematic reviews, 2018Co-Authors: Dawid Pieper, Julian-dario Rembe, Tanja Rombey, Johannes Doerner, Hubert Zirngibl, Konstantinos Zarras, Peter C. AmbeAbstract:Surgical site infection describes an infectious complication of surgical Wounds. This single complication is thought to occur in close to 20% of surgical cases. This complication has been described in all kinds of surgical procedure including minimally invasive procedures. Wound Irrigation is frequently used as a means of reducing surgical site infection. However, there is lack of solid evidence to support routine Wound Irrigation. The aim of this review is to provide evidence for the efficacy of routine Wound Irrigation with normal saline in preventing surgical site infection. The rate of surgical site infection in cases with and without Wound Irrigation will be analyzed. Systematic literature searches will be conducted to identify all published and unpublished studies. The following databases will be searched for citations from inception to present: MEDLINE (via PubMed), Embase (via Embase), and CENTRAL (via the Cochrane library). The search strategy will be developed by the research team in collaboration with an experienced librarian and checked by a referee according to the Peer Review of Electronic Search Strategies (PRESS) guideline. A draft of the PubMed search strategy could be (Irrigation[tiab] OR “Therapeutic Irrigation”[mesh] OR lavage[tiab]) AND (saline[tiab] OR “Sodium Chloride”[mesh] OR sodium chloride[tiab]) NOT (“Comment” [Publication Type] OR “Letter” [Publication Type] OR “Editorial” [Publication Type]). No time limits will be set. The reference lists of eligible articles will be hand searched. Relevant data will be extracted from eligible studies using a previously designed data extraction sheet. Relative risks will be calculated for binary outcomes and mean differences or standardized mean differences, if necessary, for continuous outcomes. For all measures, 95% confidence levels will be calculated. Both arms would be compared with regard to the rate of surgical site infection within 30 days following surgery. We will report the review using the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) statement. This review aims at investigating the value of routine Wound Irrigation using normal saline in preventing surgical site infection. PROSPERO: CRD42018082287
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The role of saline Irrigation prior to Wound closure in the reduction of surgical site infection: protocol for a systematic review and meta-analysis
BMC, 2018Co-Authors: Dawid Pieper, Julian-dario Rembe, Tanja Rombey, Johannes Doerner, Hubert Zirngibl, Konstantinos Zarras, Peter C. AmbeAbstract:Abstract Background Surgical site infection describes an infectious complication of surgical Wounds. This single complication is thought to occur in close to 20% of surgical cases. This complication has been described in all kinds of surgical procedure including minimally invasive procedures. Wound Irrigation is frequently used as a means of reducing surgical site infection. However, there is lack of solid evidence to support routine Wound Irrigation. The aim of this review is to provide evidence for the efficacy of routine Wound Irrigation with normal saline in preventing surgical site infection. The rate of surgical site infection in cases with and without Wound Irrigation will be analyzed. Methods/design Systematic literature searches will be conducted to identify all published and unpublished studies. The following databases will be searched for citations from inception to present: MEDLINE (via PubMed), Embase (via Embase), and CENTRAL (via the Cochrane library). The search strategy will be developed by the research team in collaboration with an experienced librarian and checked by a referee according to the Peer Review of Electronic Search Strategies (PRESS) guideline. A draft of the PubMed search strategy could be (Irrigation[tiab] OR “Therapeutic Irrigation”[mesh] OR lavage[tiab]) AND (saline[tiab] OR “Sodium Chloride”[mesh] OR sodium chloride[tiab]) NOT (“Comment” [Publication Type] OR “Letter” [Publication Type] OR “Editorial” [Publication Type]). No time limits will be set. The reference lists of eligible articles will be hand searched. Relevant data will be extracted from eligible studies using a previously designed data extraction sheet. Relative risks will be calculated for binary outcomes and mean differences or standardized mean differences, if necessary, for continuous outcomes. For all measures, 95% confidence levels will be calculated. Both arms would be compared with regard to the rate of surgical site infection within 30 days following surgery. We will report the review using the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) statement. Discussion This review aims at investigating the value of routine Wound Irrigation using normal saline in preventing surgical site infection. Systematic review registration PROSPERO: CRD4201808228
Barry J. Gainor - One of the best experts on this subject based on the ideXlab platform.
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Surfactant Wound Irrigation for the treatment of staphylococcal clinical isolates.
Clinical orthopaedics and related research, 2002Co-Authors: Kazmier P, Jeffrey O Anglen, W. A. Simpson, Gordon D. Christensen, Kelly J. Hendricks, Barry J. GainorAbstract:Deep Wound infection involving an implanted biomaterial is a devastating complication in orthopaedic surgery. Two-thirds of such infections are monomicrobial and the most commonly isolated bacteria in human osteomyelitis and orthopaedic device infection are Staphylococcus aureus and Staphylococcus epidermidis. The purpose of the current study was to examine the effectiveness of the previously reported sequential surfactant Irrigation protocol against human-isolated clinical strains of Staphylococcus aureus and Staphylococcus epidermidis in the rat model of orthopaedic implant contamination. The infectivity rate of human-isolated clinical strains of Staphylococcus aureus in a contaminated complex orthopaedic Wound was reduced effectively by a sequential surfactant Irrigation protocol. Also, in this model, the infectivity of Staphylococcus epidermidis was reduced by normal saline Irrigation alone when compared with no Irrigation. Therefore, the sequential surfactant Irrigation protocol may represent an effective method of Wound Irrigation in monomicrobial Staphylococcus aureus orthopaedic implant contamination, and normal saline Irrigation may suffice in cases of monomicrobial Staphylococcus epidermidis contamination. Additional studies are necessary to determine the clinical use of surfactant Irrigation.
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Surfactant Wound Irrigation for the treatment of staphylococcal clinical isolates : Orthopaedic infections
Clinical Orthopaedics and Related Research, 2002Co-Authors: Kevin Marberry, Jeffrey O Anglen, W. A. Simpson, Gordon D. Christensen, Kelly J. Hendricks, Pete Kazmier, J. Glenn Phaup, Barry J. GainorAbstract:Deep Wound infection involving an implanted biomaterial is a devastating complication in orthopaedic surgery. Two-thirds of such infections are monomicrobial and the most commonly isolated bacteria in human osteomyelitis and orthopaedic device infection are Staphylococcus aureus and Staphylococcus epidermidis. The purpose of the current study was to examine the effectiveness of the previously reported sequential surfactant Irrigation protocol against human-isolated clinical strains of Staphylococcus aureus and Staphylococcus epidermidis in the rat model of orthopaedic implant contamination. The infectivity rate of human-isolated clinical strains of Staphylococcus aureus in a contaminated complex orthopaedic Wound was reduced effectively by a sequential surfactant Irrigation protocol. Also, in this model, the infectivity of Staphylococcus epidermidis was reduced by normal saline Irrigation alone when compared with no Irrigation. Therefore, the sequential surfactant Irrigation protocol may represent an effective method of Wound Irrigation in monomicrobial Staphylococcus aureus orthopaedic implant contamination, and normal saline Irrigation may suffice in cases of monomicrobial Staphylococcus epidermidis contamination. Additional studies are necessary to determine the clinical use of surfactant Irrigation.
