Safety of Prophylactic Intra-Operative Wound Irrigation for SSIs

safety of prophylactic intra-operative wound irrigation for prevention of surgical site infections

| Posted in: Science

Journal name: World Journal of Pharmaceutical Research
Original article title: Meta-analysis
The WJPR includes peer-reviewed publications such as scientific research papers, reports, review articles, company news, thesis reports and case studies in areas of Biology, Pharmaceutical industries and Chemical technology while incorporating ancient fields of knowledge such combining Ayurveda with scientific data.
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Subtitle: myopia in patients with open-angle glaucoma

Original source:

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Author:

Jumanah Jameel Homsi, Omar Khalid Alsaawi, Dai Samran Almutairi, Najlaa Samran Almutairi, Malak Khalid Alkuwaykibi, Abdulaziz Hussam Abed, Sara Nasser Albqami, Fahad Saud Alanazi, Mohammad Hamid Alfallaj, Faisal Mahmoud Turkistani, Abdulrahman Ghazi Alqurashi


World Journal of Pharmaceutical Research:

(An ISO 9001:2015 Certified International Journal)

Full text available for: Meta-analysis

Source type: An International Peer Reviewed Journal for Pharmaceutical and Medical and Scientific Research

Doi: 10.20959/wjpr201913-16369

Copyright (license): WJPR: All rights reserved


Summary of article contents:

Introduction

Surgical site infections (SSIs) represent a significant healthcare concern, attributed to various factors associated with surgical procedures. With SSIs constituting around 31% of all healthcare-associated infections, it is crucial to implement effective preventive strategies. Prophylactic intra-operative wound irrigation (pIOWI) is one such strategy, which aims to reduce the rate of infection by employing antiseptic or antibiotic solutions during surgery. This study analyzed the effectiveness and safety of different solutions used for pIOWI to provide evidence-based recommendations for the prevention of SSIs.

Efficacy of Povidone-Iodine Irrigation

One of the key findings of the review was the effectiveness of povidone-iodine (PVP-I) irrigation in reducing SSIs. The meta-analysis of six studies involving a total of 2,428 patients demonstrated that those in the intervention group using PVP-I experienced significantly fewer surgical site infections in comparison to those in the control group who received saline irrigation. The statistical analysis yielded a p-value of 0.038, indicating a strong significance in favor of PVP-I, aligning with previous research that indicated its superiority over saline in minimizing infection rates.

Analysis of Study Methodology

The systematic review utilized rigorous methodologies, adhering to standards outlined in the Cochrane handbook and the PRISMA statement. By searching comprehensive data sources like PubMed, Cochrane Library Ovid, Scopus, and Google Scholar, the researchers identified relevant randomized controlled trials (RCTs), clinical trials, and comparative studies published between 2005 and 2019. This thorough approach ensured that only English-language publications that fulfilled specific inclusion criteria were included, further strengthening the validity of the findings.

Safety and Outcomes

The safety of PVP-I usage during wound irrigation was also a focal point of the analysis. In assessing the occurrence of serious adverse events related to the intervention, the study employed a random-effects model for its meta-analysis, revealing an overall odds ratio of 0.25. This indicates a marked reduction in bacterial infections and supports the claim that PVP-I irrigation does not adversely affect clinical outcomes. The results corroborate with other studies in the field that advocate for PVP-I's implementation as a standard practice in surgical procedures.

Conclusion

In conclusion, the study provided compelling evidence that prophylactic intra-operative wound irrigation using povidone-iodine is effective in reducing post-operative surgical wound infections without negatively influencing clinical outcomes. Given the increasing incidence of surgical site infections and their associated morbidity and healthcare costs, implementing PVP-I as a routine practice could contribute positively to surgical care. Further investigations may enhance our understanding of the long-term effects and potential systemic impacts of various irrigation solutions, thereby optimizing surgical protocols for better patient outcomes.

FAQ section (important questions/answers):

What is the purpose of prophylactic intra-operative wound irrigation (pIOWI)?

The purpose of pIOWI is to physically remove contaminants and reduce surgical site infections (SSIs) by using solutions like povidone-iodine to enhance local antibacterial action during surgery.

How was the efficacy of pIOWI measured in the study?

The efficacy of pIOWI was measured by comparing rates of surgical site infections in two groups: the intervention group using povidone-iodine and the control group using saline irrigation.

What were the key findings regarding surgical site infections?

The meta-analysis showed a significant decrease in surgical site infections in the intervention group, with a p-value of 0.038, indicating povidone-iodine is effective compared to saline.

What types of surgeries were included in the meta-analysis?

The meta-analysis included various surgeries such as spine surgery, orthopedic surgery, vascular surgery, and cesarean sections. A total of six studies were analyzed.

What is the main conclusion of the study on pIOWI?

The study concludes that povidone-iodine irrigation effectively reduces postoperative surgical wound infections without negatively impacting clinical outcomes.

What are the potential risks associated with using povidone-iodine?

While povidone-iodine is effective, potential risks include allergies and metabolic adverse events. However, its benefits in reducing infections may outweigh these concerns in many cases.

Glossary definitions and references:

Scientific and Ayurvedic Glossary list for “Safety of Prophylactic Intra-Operative Wound Irrigation for SSIs”. This list explains important keywords that occur in this article and links it to the glossary for a better understanding of that concept in the context of Ayurveda and other topics.

1) Study (Studying):
The term 'Study' is critical in research as it represents a systematic investigation designed to develop or contribute to generalizable knowledge. In this context, it pertains to the systematic review and meta-analysis that evaluates the effectiveness and safety of prophylactic intra-operative wound irrigation. Various studies were reviewed to consolidate data and draw conclusions regarding surgical site infections.

2) Surface:
In the medical context, 'Surface' refers to the outermost layer of tissue where surgical procedures occur. The surface of the incision site is relevant for wound irrigation, as effective cleaning and antisepsis can minimize the risk of surgical site infections by removing contaminants on the surface and reducing microbial load.

3) Antibiotic (Antibacterial):
Antibacterial agents are important in preventing bacterial growth and infection. The article discusses the use of povidone-iodine, an antibacterial solution, in surgical wound irrigation. Evaluating the effectiveness of such agents in reducing infections is paramount, as it informs clinical practices for improving surgical outcomes.

4) Table:
The term 'Table' here refers to structured representations of data, specifically summarizing study characteristics and results. Tables in the article present information about patient demographics, outcomes, and rates of surgical site infections, which enable a clear visual understanding of research findings and comparative analyses.

5) King:
In this context, 'King' signifies affiliation with King Khalid University Hospital, where the lead author interned. This indicates institutional backing for the work conducted and reflects the contributions from numerous practitioners and students associated with the healthcare facility, enhancing the credibility of the research.

6) Allam:
'Allam' refers to one of the authors contributing to the article. The inclusion of diverse authors from various medical backgrounds enhances the research's reliability. Notably, the inclusion of findings from Allam's studies showcases the collaborative effort in investigating the effectiveness of wound irrigation techniques.

7) Water:
'Water' is a solvent often used in medical applications, including wound irrigation solutions. In this study, it denotes the environment in which antiseptic solutions are formulated. Its role in diluting and facilitating the application of medicinal agents highlights its significance in preventing infections in surgical procedures.

8) Chang:
'Chang' is another author mentioned within the research. The contributions from Chang and others allow for a broader perspective in the study. Individual studies like those conducted by Chang are integral to the meta-analysis, providing essential data for understanding the impact of different irrigation techniques on surgical infections.

9) Ovid:
'Ovid' refers to a digital database that hosts a variety of medical literature. Its mention indicates the comprehensive reach of the systematic search conducted for this study. Utilizing reputable databases such as Ovid enhances the study's legitimacy by sourcing reliable and peer-reviewed articles for analysis.

10) Discussion:
The 'Discussion' section in research is crucial for interpreting results, drawing connections to existing literature, and offering insights into implications and future directions. Here, the discussion examines the findings of the meta-analysis, compares them with other studies, and addresses differing opinions on the use of wound irrigation solutions.

11) Toxicity:
'Toxicity' refers to the degree to which a substance can harm organisms. In the context of the research, it highlights concerns regarding the effects of certain wound irrigation solutions, such as povidone-iodine. Understanding toxicity profiles is vital when assessing the safety of antiseptic agents used during surgical procedures and their potential impacts.

12) Activity:
'Activity' in this context refers to the effectiveness of specific agents used in surgical environments, such as their ability to inhibit microbial growth. The evaluation of antibacterial activity is essential for understanding how different irrigation solutions can contribute to reducing infection rates and improving patient outcomes in surgeries.

13) Incision:
An 'incision' denotes a cut made during surgery to access internal structures. Its relevance in this study is significant, as the focus lies in preventing infections in surgical wounds. The manipulation and management of incisions dictate the need for effective irrigation methods that assess and reduce contamination risk.

14) Science (Scientific):
'Science' is a systematic enterprise that builds and organizes knowledge through observation, experimentation, and analysis. Its importance in the article lies in the adherence to scientific methodologies for conducting reviews and analyses of existing literature, ensuring that conclusions drawn are evidence-based and valid.

15) Quality:
'Quality' denotes the standard of care in medical practices, which is paramount when reviewing studies on infection prevention. High-quality evidence in this meta-analysis directly informs best practices in surgical wound management, with an emphasis on effective methods to minimize surgical site infection rates.

16) Forest:
'Forest' refers to the 'forest plot,' a graphical representation used in meta-analysis to depict the results of individual studies together with the overall effect. It aids in visually assessing the effectiveness of interventions across multiple studies, making it easier to interpret the probability of outcomes based on pooled data.

17) Debate:
'Debate' indicates a discussion or argument on differing views surrounding a topic. In this article, it reflects the disagreements in the literature regarding the effectiveness of certain irrigation solutions. Issues of safety and clinical outcomes based on various studies illustrate the ongoing debate in the medical community.

18) Doubt:
'Doubt' in medical research pertains to uncertainty regarding the effectiveness or safety of treatment options. This article acknowledges such uncertainties surrounding different irrigation methods. Addressing doubt is crucial in scientific discourse, guiding future inquiries and helping refine clinical practices based on available evidence.

19) Wall:
'Wall' could refer to a cellular or structural boundary. In this research, understanding the integrity of barriers, such as skin or cell walls, is important in the context of eliminating bacteria and preventing infections. The management of these structural challenges is key to effective surgical outcomes.

20) Asma (Ashma):
'Asma' is another author among the contributors. The collective knowledge and expertise of authors like Asma ensure that the findings of the article are comprehensive and rooted in a thorough understanding of the topic. Each author's research enhances the overall depth of the analysis provided within the study.

21) Cina:
'Sina' refers to Ibn Sina National College, an institution associated with one of the co-authors. This affiliation suggests credibility and expertise within the study. Mentioning respected institutions emphasizes the scholarly nature of the article while contributing to the strength of the findings presented.

Other Science Concepts:

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Discover the significance of concepts within the article: ‘Safety of Prophylactic Intra-Operative Wound Irrigation for SSIs’. Further sources in the context of Science might help you critically compare this page with similair documents:

Control group, Meta analysis, Cochrane Library, PubMed, Intervention group, Povidone-iodine solution, Early identification, Risk factor, Surgical site infection, Surgical Strategies, Hospitalized patients, Hospital acquired infection, Random-effects model, Adverse outcome, Topical antibiotics, Cochrane Collaboration.

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