Subcutaneous irrigation with rifampicin <i>vs.</i> povidone-iodine for the prevention of incisional surgical site infections following caesarean section: a prospective, randomised, controlled trial

Karuserci, Özge Kömürcü; Sucu, Seyhun

doi:10.1080/01443615.2021.1964453

Cited by 2 publications

(9 citation statements)

References 36 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Reasons for exclusion after full-text review are listed in eTable 1 in Supplement 1. We included 41 RCTs in our systematic review and 37 RCTs in the network meta-analysis, due to lack of events in all arms in 4 studies . The study characteristics of the RCTs included in the systematic review are listed in eTable 2 in Supplement 1.…”

Section: Resultsmentioning

confidence: 99%

“…The antibiotics applied in a solution in the different studies were cefazolin, gentamicin, rifampicin, imipenem, clindamycin, ceftriaxone, metronidazole, and bacitracin . All but 2 studies described the antibiotic solutions to be aqueous.…”

Section: Resultsmentioning

confidence: 99%

“…All but 2 studies described the antibiotic solutions to be aqueous. All antiseptic solutions studied were aqueous, with 18 RCTs investigating iodine solutions ranging from 0.1% to 10% in concentration. Other antiseptics used were polyhexanide, chlorhexidine, hydrogen peroxide, and electrolyzed strongly acidic aqueous solution .…”

Section: Resultsmentioning

confidence: 99%

See 2 more Smart Citations

Incisional Wound Irrigation for the Prevention of Surgical Site Infection

Groenen,

Bontekoning,

Jalalzadeh

et al. 2024

JAMA Surg

View full text Add to dashboard Cite

ImportanceSurgical site infections (SSIs) are common postoperative complications and associated with significant morbidity, mortality, and costs. Prophylactic intraoperative incisional wound irrigation is used to reduce the risk of SSIs, and there is great variation in the type of irrigation solutions and their use.ObjectiveTo compare the outcomes of different types of incisional prophylactic intraoperative incisional wound irrigation for the prevention of SSIs in all types of surgery.Data SourcesPubMed, Embase, CENTRAL, and CINAHL databases were searched up to June 12, 2023.Study SelectionIncluded in this study were randomized clinical trials (RCTs) comparing incisional prophylactic intraoperative incisional wound irrigation with no irrigation or comparing irrigation using different types of solutions, with SSI as a reported outcome. Studies investigating intracavity lavage were excluded.Data Extraction and SynthesisThis systematic review and network meta-analysis is reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis statement. Two reviewers independently extracted the data and assessed the risk of bias within individual RCTs using the Cochrane Risk of Bias 2 tool and the certainty of evidence using the Grading of Recommendations, Assessment, Development, and Evaluation framework. A frequentist network meta-analysis was conducted, and relative risks (RRs) with corresponding 95% CIs were reported.Main Outcome and MeasureThe primary study outcome was SSI.ResultsA total of 1587 articles were identified, of which 41 RCTs were included in the systematic review, with 17 188 patients reporting 1328 SSIs, resulting in an overall incidence of 7.7%. Compared with no irrigation, antiseptic solutions (RR, 0.60; 95% CI, 0.44-0.81; high level of certainty) and antibiotic solutions (RR, 0.46; 95% CI, 0.29-0.73; low level of certainty) were associated with a beneficial reduction in SSIs. Saline irrigation showed no statistically significant difference compared with no irrigation (RR, 0.83; 95% CI, 0.63-1.09; moderate level of certainty).Conclusions and RelevanceThis systematic review and network meta-analysis found high-certainty evidence that prophylactic intraoperative incisional wound irrigation with antiseptic solutions was associated with a reduction in SSIs. It is suggested that the use of antibiotic wound irrigation be avoided due to the inferior certainty of evidence for its outcome and global antimicrobial resistance concerns.

show abstract

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

Incisional Wound Irrigation for the Prevention of Surgical Site Infection

Groenen,

Bontekoning,

Jalalzadeh

et al. 2024

JAMA Surg

View full text Add to dashboard Cite

show abstract

“…Less than one third of studies (32%) were considered to be large studies with over 500 participants, with the majority of studies conducted in high-income [21] countries (74%) and on orthopaedic procedures (25%). All seven studies from lower [22–26] and upper middle-income countries [27,28] were smaller studies with less than 500 participants.…”

Section: Latest Research For Surgical Antimicrobial Prophylaxismentioning

confidence: 99%

“…We identified three key trials that clearly included SSIs as an outcome measure; of which two had less than 300 patients [23,27]. The other key study was a secondary analysis [44] of the Caesarean Section Optimal Antibiotic Prophylaxis (C/SOAP) study, a large multicenter RCT [65].…”

Section: Obstetrics and Gynaecological Surgerymentioning

confidence: 99%

Surgical site infection prophylaxis: what have we learned and are we making progress?

Ierano,

Hall,

James

2023

Current Opinion in Infectious Diseases

View full text Add to dashboard Cite

Purpose of review This review aims to discuss the current state of surgical antimicrobial prophylaxis (SAP) evidence for surgical site infection prevention. Despite decades of research, knowledge gaps persist in identifying optimal SAP regimens. Recent findings Recent randomised controlled trials highlight ongoing heterogeneity in study design. Key new findings support the use of oral preoperative SAP for colorectal surgery and advise against the use of SAP for transperineal prostate biopsy. There is growing evidence for culture-based SAP over empiric use for transrectal prostate biopsy. Contentious issues remain regarding topical antimicrobials for cardiac procedures involving sternotomy, the necessity of SAP for wire lumpectomy and laparoscopic cholecystectomy for both mild or moderate acute cholecystitis. Procedures where SAP is not indicated, yet research is still being conducted on this topic include dental implants and clean orthopaedic procedures. Summary Research efforts continue with numerous trials published and registered to determine optimal SAP regimens. However, many efforts are suboptimal due to poor statistical design and redundant questions already answered by existing literature. To improve practice and influence surgeons prescribing behaviour future RCTs should be well powered, with large sample sizes across multiple sites, focusing on clinically relevant questions.

show abstract

Subcutaneous irrigation with rifampicin vs. povidone-iodine for the prevention of incisional surgical site infections following caesarean section: a prospective, randomised, controlled trial

Cited by 2 publications

References 36 publications

Incisional Wound Irrigation for the Prevention of Surgical Site Infection

Incisional Wound Irrigation for the Prevention of Surgical Site Infection

Surgical site infection prophylaxis: what have we learned and are we making progress?

Contact Info

Product

Resources

About