Wound irrigation and peritoneal lavage with antiseptic/antibiotic solution before wound closure during gastrointestinal surgery: a systematic review and meta-analysis
Motoi Uchino,
Koji Tamura,
Shinsuke Nomura,
Seiichi Shinji,
Keita Kouzu,
Hiroji Shinkawa,
Tomohiro Ishinuki,
Toru Mizuguchi,
Hiroki Ohge,
Seiji Haji,
Junzo Shimizu,
Yasuhiko Mohri,
Chizuru Yamashita,
Yuichi Kitagawa,
Katsunori Suzuki,
Motomu Kobayash,
Masahiro Kobayashi,
Yuki Hanai,
Hiroshi Nobuhara,
Hiroki Imaoka,
Masahiro Yoshida,
Toshihiko Mayumi,
Hiroki Ikeuchi,
on behalf of SSI Prevention Guideline Committee in Japan Society for Surgical Infection
Affiliations
Motoi Uchino
Department of Gastroenterological Surgery, Division of Inflammatory Bowel Disease, Hyogo Medical University
Koji Tamura
Department of Surgery and Oncology Graduate School of Medical Sciences, Kyushu University
Shinsuke Nomura
Department of Surgery, Hayamizu-Park Clinic
Seiichi Shinji
Department of Gastrointestinal and Hepato-Biliary-Pancreatic Surgery, Nippon Medical School
Keita Kouzu
Department of Surgery, National Defence Medical College
Hiroji Shinkawa
Department of Hepatobiliary-Pancreatic Surgery, Osaka Metropolitan University Graduate School of Medicine
Tomohiro Ishinuki
Department of Nursing, Division of Surgical Science, Sapporo Medical University
Toru Mizuguchi
Department of Nursing, Division of Surgical Science, Sapporo Medical University
Hiroki Ohge
Department of Infectious Disease, Hiroshima University Hospital
Seiji Haji
Department of Surgery, Soseikai General Hospital
Junzo Shimizu
Department of Surgery, Toyonaka Municipal Hospital
Yasuhiko Mohri
Department of Gastrointestinal Surgery, Mie Prefectural General Medical Center
Chizuru Yamashita
Department of Anesthesiology and Critical Care Medicine, Fujita Health University
Yuichi Kitagawa
Department of Gastrointestinal Surgery, National Center for Geriatrics and Gerontology
Katsunori Suzuki
Department of Infection Control, Hospital of the University of Occupational and Environmental Health
Motomu Kobayash
Department of Anesthesiology, Hokushinkai Megumino Hospital
Masahiro Kobayashi
Department of Clinical Pharmacokinetics, Research and Education Center for Clinical Pharmacy, Kitasato University Hospital
Yuki Hanai
Department of Clinical Pharmacy, Faculty of Pharmaceutical Sciences, Toho University
Hiroshi Nobuhara
Department of Dentistry, Hiroshima Prefectural Hospital
Hiroki Imaoka
Department of Gastrointestinal and Pediatric Surgery, Mie University Graduate School of Medicine
Masahiro Yoshida
Department of Hepato-Biliary-Pancreatic and Gastrointestinal Surgery, School of Medicine, International University of Health and Welfare
Toshihiko Mayumi
Department of Intensive Care Unit, Japan Community Healthcare Organization Chukyo Hospital
Hiroki Ikeuchi
Department of Gastroenterological Surgery, Division of Inflammatory Bowel Disease, Hyogo Medical University
on behalf of SSI Prevention Guideline Committee in Japan Society for Surgical Infection
Abstract Background Surgical site infections (SSIs) can affect mortality, morbidity, and medical costs. Although it has recently been reported that washing with antiseptic/antibiotic solution can prevent SSI in clean surgery, the clinical impact in gastrointestinal surgery is still uncertain. Therefore, we performed a systematic review and meta-analysis to evaluate the efficacy of antiseptic/antibiotic solution during wound irrigation or peritoneal lavage in gastroenterological surgery. Methods The database search used PubMed, MEDLINE, and Cochrane Library. The following inclusion criteria were set for the systematic review. 1) Studies comparing with or without antiseptic/antibiotic irrigation/lavage during gastrointestinal surgery. 2) Studies that described surgical site infections and adverse events. 3) Studies conducted after 2000. Results A total of 8 randomized controlled studies (RCTs) and 3 observational studies were included in this meta-analysis. Three RCTs of wound irrigation with povidone iodine (PVI) solution revealed no significant difference between the PVI and control groups [RR 1.41, 95% CI (0.92 to 2.17): p = 0.69]. Three RCTs of peritoneal lavage with antibiotic solution showed no significant difference between the interventional group and control groups [RR 0.39, 95% CI (0.10 to 1.55): p = 0.18]. Regarding other antiseptic or antibiotic solutions, the number of studies and participants were too small for evaluation. Conclusion Wound irrigation and peritoneal lavage with antiseptic/antibiotic solution did not have enough efficacy for preventing SSI during gastroenterological surgery.
