Prophylaxis with nasal decolonization in patients submitted to total knee and hip arthroplasty: systematic review and meta-analysis
ABSTRACT Despite the evolution of the total knee and hip arthroplasty surgery, high postoperative complication rates in the short and long term still persist. Infection is one of the most challenging complications; due to its gravity and treatment difficulties, prophylaxis protocols have been create...
Main Authors: | , , , , , |
---|---|
Format: | Article |
Language: | English |
Published: |
Sociedade Brasileira de Ortopedia e Traumatologia
|
Series: | Revista Brasileira de Ortopedia |
Subjects: | |
Online Access: | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0102-36162017000600631&lng=en&tlng=en |
id |
doaj-7e0de039f2614cffae90551ebb80bb63 |
---|---|
record_format |
Article |
spelling |
doaj-7e0de039f2614cffae90551ebb80bb632020-11-25T00:20:38ZengSociedade Brasileira de Ortopedia e TraumatologiaRevista Brasileira de Ortopedia1982-437852663163710.1016/j.rboe.2016.10.018S0102-36162017000600631Prophylaxis with nasal decolonization in patients submitted to total knee and hip arthroplasty: systematic review and meta-analysisDavid SadigurskyHenrique Santos PiresSaulo Américo Caldas RiosFrancisco Luiz Borja Rodrigues FilhoGustavo Castro de QueirozMateus Lemos AziABSTRACT Despite the evolution of the total knee and hip arthroplasty surgery, high postoperative complication rates in the short and long term still persist. Infection is one of the most challenging complications; due to its gravity and treatment difficulties, prophylaxis protocols have been created to decrease its incidence. The objective of this study was to evaluate the impact of the prophylaxis protocol for methicillin-resistant Staphylococcus aureus decolonization of the nares in patients previously identified by swab cultures, who were to be submitted to a total joint arthroplasty. A systematic review with meta-analysis was conducted, following the PRISMA-2015 protocol, using the descriptors: “arthroplasty” and “nasal decolonization,” or “joint arthroplasty” and “decolonization,” or “joint arthroplasty” and “nasal decolonization,” for final selection of four observational studies from 79 references identified. This study included a total sample of 10,179 patients, divided in two groups: the control group (4788 patients) and intervention group (5391 patients). It was observed that the intervention group, in which prophylaxis with nasal decolonization was used, 59 (1.09%) of the patients developed a surgical site infection, while in the control group there were 86 cases of surgical site infection (1.79%). This trend repeated itself in all articles, showing no publication biases, forming a homogeneous sample. The use of a prophylaxis protocol for decolonization of methicillin-resistant Staphylococcus aureus, reduced surgical site infection cases by approximately 39%.http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0102-36162017000600631&lng=en&tlng=enArtroplastiaProfilaxiaInfecçãoDescontaminação |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
David Sadigursky Henrique Santos Pires Saulo Américo Caldas Rios Francisco Luiz Borja Rodrigues Filho Gustavo Castro de Queiroz Mateus Lemos Azi |
spellingShingle |
David Sadigursky Henrique Santos Pires Saulo Américo Caldas Rios Francisco Luiz Borja Rodrigues Filho Gustavo Castro de Queiroz Mateus Lemos Azi Prophylaxis with nasal decolonization in patients submitted to total knee and hip arthroplasty: systematic review and meta-analysis Revista Brasileira de Ortopedia Artroplastia Profilaxia Infecção Descontaminação |
author_facet |
David Sadigursky Henrique Santos Pires Saulo Américo Caldas Rios Francisco Luiz Borja Rodrigues Filho Gustavo Castro de Queiroz Mateus Lemos Azi |
author_sort |
David Sadigursky |
title |
Prophylaxis with nasal decolonization in patients submitted to total knee and hip arthroplasty: systematic review and meta-analysis |
title_short |
Prophylaxis with nasal decolonization in patients submitted to total knee and hip arthroplasty: systematic review and meta-analysis |
title_full |
Prophylaxis with nasal decolonization in patients submitted to total knee and hip arthroplasty: systematic review and meta-analysis |
title_fullStr |
Prophylaxis with nasal decolonization in patients submitted to total knee and hip arthroplasty: systematic review and meta-analysis |
title_full_unstemmed |
Prophylaxis with nasal decolonization in patients submitted to total knee and hip arthroplasty: systematic review and meta-analysis |
title_sort |
prophylaxis with nasal decolonization in patients submitted to total knee and hip arthroplasty: systematic review and meta-analysis |
publisher |
Sociedade Brasileira de Ortopedia e Traumatologia |
series |
Revista Brasileira de Ortopedia |
issn |
1982-4378 |
description |
ABSTRACT Despite the evolution of the total knee and hip arthroplasty surgery, high postoperative complication rates in the short and long term still persist. Infection is one of the most challenging complications; due to its gravity and treatment difficulties, prophylaxis protocols have been created to decrease its incidence. The objective of this study was to evaluate the impact of the prophylaxis protocol for methicillin-resistant Staphylococcus aureus decolonization of the nares in patients previously identified by swab cultures, who were to be submitted to a total joint arthroplasty. A systematic review with meta-analysis was conducted, following the PRISMA-2015 protocol, using the descriptors: “arthroplasty” and “nasal decolonization,” or “joint arthroplasty” and “decolonization,” or “joint arthroplasty” and “nasal decolonization,” for final selection of four observational studies from 79 references identified. This study included a total sample of 10,179 patients, divided in two groups: the control group (4788 patients) and intervention group (5391 patients). It was observed that the intervention group, in which prophylaxis with nasal decolonization was used, 59 (1.09%) of the patients developed a surgical site infection, while in the control group there were 86 cases of surgical site infection (1.79%). This trend repeated itself in all articles, showing no publication biases, forming a homogeneous sample. The use of a prophylaxis protocol for decolonization of methicillin-resistant Staphylococcus aureus, reduced surgical site infection cases by approximately 39%. |
topic |
Artroplastia Profilaxia Infecção Descontaminação |
url |
http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0102-36162017000600631&lng=en&tlng=en |
work_keys_str_mv |
AT davidsadigursky prophylaxiswithnasaldecolonizationinpatientssubmittedtototalkneeandhiparthroplastysystematicreviewandmetaanalysis AT henriquesantospires prophylaxiswithnasaldecolonizationinpatientssubmittedtototalkneeandhiparthroplastysystematicreviewandmetaanalysis AT sauloamericocaldasrios prophylaxiswithnasaldecolonizationinpatientssubmittedtototalkneeandhiparthroplastysystematicreviewandmetaanalysis AT franciscoluizborjarodriguesfilho prophylaxiswithnasaldecolonizationinpatientssubmittedtototalkneeandhiparthroplastysystematicreviewandmetaanalysis AT gustavocastrodequeiroz prophylaxiswithnasaldecolonizationinpatientssubmittedtototalkneeandhiparthroplastysystematicreviewandmetaanalysis AT mateuslemosazi prophylaxiswithnasaldecolonizationinpatientssubmittedtototalkneeandhiparthroplastysystematicreviewandmetaanalysis |
_version_ |
1725366221813055488 |