Abstract:
OBJECTIVE To systematically review the effectiveness of evidence-based infection control care bundles to reduce surgical site infection (SSI) among patients undergoing colorectal surgery.
METHODS The literature about the impact of evidence-based infection control care bundles to reduce surgical site infection was retrieved from digital databases of PubMed, Embase, CINAHL, Scopus, Ovid, The Cochrane library, CNKI, VIP, CBM and WanFang data(from establishment to Jun. 2018). The literature contained randomized controlled trials (RCTs) and clinical control studies (CCTs). The Meta-analysis and subgroup analysis were performed after searching and screening databases, extracting data and assessing the quality of included studies using RevMan 5.3.
RESULTS Fourteen published studies with 8562 patients were included for Meta-analysis, which contained 3 RCTs and 11 CCTs.The Meta-analysis results showed that, compared with single measures, the evidence-based infection control care bundles could effectively prevent the risk of surgical site infections in patients undergoing colorectal surgery, and the difference was significant
RR=0.55,95%
CI:0.39-0.77;
P=0.002. In superficial infection and deep infection, there was no significant difference between infection control care bundles and single measures. However, in organ space infection, there was significant difference in infection rate between infection control care bundles and single measures (
RR=0.58,95%
CI: 0.35-0.95;
P=0.03). Subgroup analysis showed that research types may be a source of heterogenity.There were significant differences between the types of subgroups (
χ2=7.15,
P=0.007). There was no significant difference between the diagnostic criteria subgroups (
χ2=1.14,
P=0.29).
CONCLUSION The systematic review and Meta-analysis documents showed that use of an evidence-based surgical care bundles in patients undergoing colorectal surgery significantly reduced the incidence of SSI and the infection rate of organ lacuna. However, in view of the bundling mode, it is suggested that further scientific research should be carried out for in-depth discussion.