Prevention of infection in arterial reconstruction

摘要: Background Arterial reconstructions with prosthetic graft materials or vein are susceptible to infection a resultant high patient mortality and risk of limb loss. To reduce the effective perioperative measures essential. Objectives To determine effectiveness strategies prevent in patients undergoing peripheral arterial reconstruction. Search methods The Cochrane Peripheral Vascular Diseases Group trials register was searched (last September 2010) Central Register Controlled Trials (CENTRAL) 2010, Issue 3), reference lists relevant articles. Selection criteria Randomised controlled (RCTs) evaluating intended surgery. Data collection analysis Two authors independently selected assessed quality included trials. Relative (RR) used as measure effect for each dichotomous outcome. Main results Thirty-five RCTs were included. Of these, 23 prophylactic systemic antibiotics, three rifampicin-bonded grafts, preoperative skin antisepsis, two suction wound drainage, minimally invasive situ bypass techniques, individual intraoperative glove change closure techniques. Wound early outcomes recorded all Only trials, both rifampicin bonding, followed up years. Trials antibiotics versus placebo highest six double-blind studies ten included. Prophylactic reduced 0.25, 95% Confidence Interval (CI) 0.17 0.38) fixed-effect model (RR 0.31, CI 0.11 0.85, P = 0.02). Antibiotic prophylaxis greater than 24 hours appears be no added benefit 1.28, 0.82 1.98). There evidence that bonding dacron grafts at either one month 0.63, 0.27 1.49) years 1.05, 0.46 2.40). There beneficial detrimental on rates groin-wound drainage 0.96 0.50 1.86) any from bathing shower regimen antiseptic agents over unmedicated 0.97, 0.70 1.36). Authors' conclusions There is clear benefits broad spectrum antibiotics. Many other interventions reconstruction lack effectiveness.