What’s going on in the operating theatre?
Those working in operating theatres do some simple things designed to reduce the likelihood of the patient getting an infection of their surgical wound. Patients may be asked to do things too, by showering with an antiseptic beforehand, for example. Do they work? Here’s the evidence from Cochrane reviewsCochrane Reviews are systematic reviews. In systematic reviews we search for and summarize studies that answer a specific research question (e.g. is paracetamol effective and safe for treating back pain?). The studies are identified, assessed, and summarized by using a systematic and predefined approach. They inform recommendations for healthcare and research.:
- It is unclear whether wearing surgical face masks by members of the surgical team has any impact on surgical wound infection rates in people having ‘clean’ surgery
- There was no evidence that plastic adhesive drapes reduce surgical site infection rates, and some evidence that they increase infection rates
- There is no clear evidence (from 7 trialsClinical trials are research studies involving people who use healthcare services. They often compare a new or different treatment with the best treatment currently available. This is to test whether the new or different treatment is safe, effective and any better than what is currently used. No matter how promising a new treatment may appear during tests in a laboratory, it must go through clinical trials before its benefits and risks can really be known. with over 10,000 people) that showering or bathing before surgery with the antiseptic chlorhexidine is better than other wash products for reducing surgical site infections
- It’s unclear whether one sort of antiseptic solution for scrubbing hands before surgery is better than another
- No trials have investigated whether wearing nail polish or finger rings affects the rateThe speed or frequency of occurrence of an event, usually expressed with respect to time. For instance, a mortality rate might be the number of deaths per year, per 100,000 people. of surgical wound infection
- Evidence from one studyAn investigation of a healthcare problem. There are different types of studies used to answer research questions, for example randomised controlled trials or observational studies. suggested that preparing the skin before surgery with 0.5% chlorhexidine in methylated spirits led to a reduced riskA way of expressing the chance of an event taking place, expressed as the number of events divided by the total number of observations or people. It can be stated as ‘the chance of falling were one in four’ (1/4 = 25%). This measure is good no matter the incidence of events i.e. common or infrequent. of surgical site infection compared with an alcohol based povidone iodine solution, but it is important to note that the trial does not report important details, such as the concentration of povidone iodine paint used, and of how the trial was done, so we can’t be confident about the findings
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Links:
Lipp A, Edwards P. Disposable surgical face masks for preventing surgical wound infection in clean surgery. Cochrane Database of Systematic ReviewsIn systematic reviews we search for and summarize studies that answer a specific research question (e.g. is paracetamol effective and safe for treating back pain?). The studies are identified, assessed, and summarized by using a systematic and predefined approach. They inform recommendations for healthcare and research. 2014, Issue 2. Art. No.: CD002929. DOI: 10.1002/14651858.CD002929.pub2.
Webster J, Alghamdi A. Use of plastic adhesive drapes during surgery for preventing surgical site infection. Cochrane Database of Systematic Reviews 2013, Issue 1. Art. No.: CD006353. DOI: 10.1002/14651858.CD006353.pub3.
Webster J, Osborne S. Preoperative bathing or showering with skin antiseptics to prevent surgical site infection. Cochrane Database of Systematic Reviews 2012, Issue 9. Art. No.: CD004985. DOI: 10.1002/14651858.CD004985.pub4.
Tanner J, Swarbrook S, Stuart J. Surgical hand antisepsis to reduce surgical site infection. Cochrane Database of Systematic Reviews 2008, Issue 1. Art. No.: CD004288. DOI: 10.1002/14651858.CD004288.pub2.
Arrowsmith VA, Taylor R. Removal of nail polish and finger rings to prevent surgical infection. Cochrane Database of Systematic Reviews 2014, Issue 8. Art. No.: CD003325. DOI: 10.1002/14651858.CD003325.pub3.
Dumville JC, McFarlane E, Edwards P, Lipp A, Holmes A. Preoperative skin antiseptics for preventing surgical wound infections after clean surgery. Cochrane Database of Systematic Reviews 2013, Issue 3. Art. No.: CD003949. DOI: 10.1002/14651858.CD003949.pub3.
