Dressing to prevent surgical site infection in adult patients with cancer: a systematic review with meta-analysis.

Autor: Dias TA; Ribeirão Preto School of Nursing, University of São Paulo (EERP/USP), Prof. Hélio Lourenço St., 3900, Ribeirão Preto, Sao Paulo, Vila Monte Alegre, Brazil., Fernandes DR; Ribeirão Preto School of Nursing, University of São Paulo (EERP/USP), Prof. Hélio Lourenço St., 3900, Ribeirão Preto, Sao Paulo, Vila Monte Alegre, Brazil., Dos Santos BN; Ribeirão Preto School of Nursing, University of São Paulo (EERP/USP), Prof. Hélio Lourenço St., 3900, Ribeirão Preto, Sao Paulo, Vila Monte Alegre, Brazil., Dos Reis PED; University of Brasilia, Asa Norte, Brasília, Distrito Federal, 70.910-900, Brazil., Margatho AS; Ribeirão Preto School of Nursing, University of São Paulo (EERP/USP), Prof. Hélio Lourenço St., 3900, Ribeirão Preto, Sao Paulo, Vila Monte Alegre, Brazil., Silveira RCCP; Ribeirão Preto School of Nursing, University of São Paulo (EERP/USP), Prof. Hélio Lourenço St., 3900, Ribeirão Preto, Sao Paulo, Vila Monte Alegre, Brazil. recris@eerp.usp.br.
Jazyk: angličtina
Zdroj: Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer [Support Care Cancer] 2022 Dec 13; Vol. 31 (1), pp. 11. Date of Electronic Publication: 2022 Dec 13.
DOI: 10.1007/s00520-022-07467-8
Abstrakt: Purpose: To identify the most effective dressing for application to surgical wounds with primary closure to prevent surgical site infection (SSI) in adult patients with cancer undergoing elective surgeries.
Methods: This systematic review was based on the Preferred Reporting Items for Systematic Reviews and Meta-Analysis, with online searches conducted in the CINHAL, Cochrane Central, LILACS, PubMed, Scopus, Embase, Livivo, and Web of Science databases. An additional search was conducted in gray literature using Google Scholar. The risk of bias was assessed using RoB 2.0. The certainty of evidence was evaluated using the Grading of Recommendations Assessment and Development and Evaluation, and the results were synthesized in a descriptive manner and using meta-analysis.
Results: Eleven randomized clinical trials were conducted to compare different types of dressing-silver dressing with absorbent dressing (n = 3), mupirocin dressing with paraffin/no dressing (n = 1), honey-based dressing with absorbent dressing (n = 1), vitamin E and silicone-containing dressing with absorbent dressing (n = 1), and negative pressure wound therapy with absorbent dressing (n = 4)-and compare the usage duration of absorbent dressing (n = 1). Nine trials presented a low risk of bias, and two were classified as having uncertain bias. Compared with absorbent dressing, silver dressing did not reduce the risk of developing any type of SSI in 894 clinical trial participants (risk relative RR: 0.72; 95% confidence interval [CI] [0.44, 1.17] p = 0.18). Compared with absorbent dressing, negative pressure wound therapy did not reduce the risk of developing any type of SSI in the 1041 participants of two clinical trials (RR 0.68; 95% CI [0.31, 1.26] p = 0.22). The certainty of evidence of the three meta-analyses was considered low or very low for the prevention of SSI. We believe that this low certainty of evidence can be improved by conducting new studies in the future.
Conclusion: There is no evidence regarding which dressing is the most effective in preventing SSI in adult patients with cancer.
(© 2022. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)
Databáze: MEDLINE
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