Preoperative hair removal and surgical site infections: network meta-analysis of randomized controlled trials

Lefebvre, A.; Saliou, Philippe; Lucet, Jean‐Christophe; Mimoz, Olivier; Keïta-Perse, Olivia; Grandbastien, Bruno; Bruyère, F.; Boisrenoult, P.; Lepelletier, Didier; Aho, Ludwig Serge

doi:10.1016/j.jhin.2015.06.020

Cited by 95 publications

(53 citation statements)

References 25 publications

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“…El mejor estudio disponible para dar una recomendación en este tópico es una revisión sistemática de "The Cochrane Library" en la que se incluyen 11 pruebas controladas aleatorizadas; tres pruebas que reunieron 625 pacientes compararon remoción del vello usando cremas depilatorias o maquinas eléctricas, con la no remoción del vello, no encontraron diferencias en los grupos en eventos de ISO; tres pruebas con 3193 personas compararon afeitado con máquina de rasurar con recorte encontrando un riesgo mayor de ISO con el primero con una diferencia estadísticamente significativa (RR 2,02, IC 95% 1,21 -3,36); siete estudios clínicos que incluyeron 1213 personas compararon afeitado y remoción del vello con crema depilatoria encontraron más riesgo de ISO con el afeitado de los pacientes (RR 1,54, IC 95% 1,05 -2,24)(Grado de recomendación A I) 26 . Una actualización reciente de este meta análisis incluyó 19 estudios y confirmó no solo la ausencia de beneficio de la depilación para disminuir la ISO, sino que la remoción del vello con máquina o la depilación química comparado con el afeitado tiene menor riesgo (RR 0,55 IC 95% 0,38-0,79; RR0.60, IC 95% 0,36-0,97, respectivamente) (Grado de recomendación A I) 27 .…”

Section: La Mañana Antes Del Ingreso Al Hospital O Clínicaunclassified

“…En aquellos pacientes que presenten vello que dificulte la cirugía se procederá solo a cortar el vello, jamás rasurar al ras con una cuchilla de afeitar, dado que este procedimiento incrementa el riesgo de ISO. -Para el corte del vello este se debe hacer mediante el uso de una maquina cortadora de vello o por medio de un agente depilatorio, que no generan abrasiones a la piel (Grado de recomendación A I) 5,22,27,28 . Sin embargo, se deben tener en cuenta que las cremas depilatorias pueden causar quemaduras química o hipersensibilidad.…”

Section: B En La Sala De Cirugíaunclassified

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Recomendaciones prácticas para la antisepsia de la piel del paciente antes de cirugía

Guevara

Valderrama

Sefair

et al. 2017

Infect

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ResumenLa búsqueda de estrategias para la disminución de la infección de sitio operatorio (ISO) es una prioridad, dado el impacto que ésta tiene en los resultados de la atención de los pacientes. Recientemente ha tomado gran relevancia en la prevención de la ISO, la preparación prequirúrgica de la piel del paciente como uno de los factores clave, en los que se puede intervenir y disminuir el riesgo. En los últimos años han aparecido revisiones exhaustivas dedicadas no solo a la comparación de las soluciones antisépticas, y técnica de aplicación, también acerca de la importancia del baño pre operatorio, uso de cintas y compresas quirúrgicas impregnadas con antisépticos y el recorte de cabello preoperatorio. En esta publicación se describen los hallazgos más importantes relacionados con la preparación antiséptica de la piel del paciente y se propone un protocolo con recomendaciones prácticas para ser implementado en las instituciones del país. Se incluyen recomendaciones basadas en niveles de evidencia sobre el uso de las soluciones antisépticas (yodopovidona, clorhexidina, clorhexidina mas alcohol, entre otras) con énfasis en las ventajas y desventajas de cada una de ellas. Keywords: Preoperative care, disinfection, Anti-Infective agents, Surgical Wound Infection Practical recommendations for skin preparation of Surgical Site AbstractThe search for strategies for reduction of Surgical Site infection (SSI) is a priority, given the impact that infections have on the outcome of the patients. The preoperative patient skin antisepsis, has recently gained greater significance in the prevention of SSI, as one of the critical factors, which can be intervened and can reduce the risk of infection. In recent years, comprehensive investigations have been published not only dedicated to the comparison of antiseptic solutions, application techniques, but also about the importance of preoperative bathing, use of surgical tapes and dressings impregnated with antiseptics, and preoperative shaving. This review outlines the key findings related to the preoperative patient's skin antisepsis and offers a protocol with practical recommendations to be implemented in the institutions of our country. It provides evidence based recommendations about the use of antiseptic solutions (povidone iodine, chlorhexidine, chlorhexidine plus alcohol, etc.) with emphasis on the advantages and disadvantages of each one.Palabras clave: Cuidados preoperatorios, desinfección, antisépticos, infección del sitio quirúrgico. REVISIÓN DE TEMA6 Médico especialista en cirugía general, departamento de cirugía, Universidad del Rosario,

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Section: La Mañana Antes Del Ingreso Al Hospital O Clínicaunclassified

Section: B En La Sala De Cirugíaunclassified

Recomendaciones prácticas para la antisepsia de la piel del paciente antes de cirugía

Guevara

Valderrama

Sefair

et al. 2017

Infect

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“…If necessary, the WHO encourages hair removal with a clipper but strongly discourages shaving, as this might create microscopic cuts in the skin, leading to microbial contamination and thereby SSI. In addition, if performed, pre-operative hair removal at the incision site should be done outside the operating room (OR) [13,15,46,47].…”

Section: Surgical-site Preparationmentioning

confidence: 99%

Prevention of fracture-related infection: a multidisciplinary care package

Metsemakers

Onsea

Neutjens

et al. 2017

International Orthopaedics (SICOT)

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Fracture-related infection (FRI) remains a challenging complication. It may result in permanent functional loss or even amputation in otherwise healthy patients. For these reasons, it is important to focus attention on prevention. In treatment algorithms for FRI, antibiotic stewardship programmes have already proved their use by means of a multidisciplinary collaboration between microbiologists, surgeons, pharmacists, infectious disease physicians and nursing staff. A similar approach, however, has not been described for infection prevention. As a first step towards achieving a multidisciplinary care package for infection prevention, this review summarises the most recent guidelines published by the World Health Organization (WHO) and US National Institutes of Health Centers for Disease Control and Prevention (CDC), primarily focusing on the musculoskeletal trauma patient. The implementation of these guidelines, together with close collaboration between infection control physicians, surgeons, anaesthesiologists and nursing staff, can potentially have a beneficial effect on the rate of FRI after musculoskeletal trauma surgery. It must be stated that most evidence presented here in support of these guidelines was not obtained from musculoskeletal trauma research. Although most preventive measures described in these studies can be generalised to the musculoskeletal trauma patient, there are still important differences with nontrauma patients that require further attention. Future research should therefore focus more on this very defined patient population and more specifically on FRI prevention.

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“…The patient should be questioned about allergies to materials used in the surgical procedure (latex, antiseptic solutions, especially those containing iodine and those associated with latex). 27 .…”

Section: Recommendationsmentioning

confidence: 99%

Practical Recommendations for Preoperative Skin Antisepsis

Guevara

Valderrama

Sefair

et al. 2017

Infect

View full text Add to dashboard Cite

The search for strategies for the reduction of Surgical Site infection (SSI) is a priority, given the impact those infections have on the outcome of the patients. The preope rative patient skin antisepsis, has recently gained greater significance in the prevention of SSI, as one of the critical factors, which can be intervened and can reduce the risk of infection. In recent years, comprehensive investigations have been published, not only dedicated to the comparison of antiseptic solutions, application techniques, but also about the importance of preoperative washing, use of surgical tapes and dressings impregnated with antiseptics, and preoperative shaving. This review outlines the key findings related to the preoperative patient's skin antisepsis and offers a protocol with practical recommendations to be implemented in the institutions of our country. It provides evidence based recommendations about the use of antiseptic solutions (povidone iodine, chlorhexidine, chlorhexidine plus alcohol, etc.) with emphasis on the advantages and disadvantages of each one.

show abstract

Preoperative hair removal and surgical site infections: network meta-analysis of randomized controlled trials

Cited by 95 publications

References 25 publications

Recomendaciones prácticas para la antisepsia de la piel del paciente antes de cirugía

Recomendaciones prácticas para la antisepsia de la piel del paciente antes de cirugía

Prevention of fracture-related infection: a multidisciplinary care package

Practical Recommendations for Preoperative Skin Antisepsis

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