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Background: Oral antiseptics reduce nosocomial infections and ventilator-associated pneumonia in critically ill medical and surgical patients intubated for prolonged periods. However, the role of oral antiseptics given before and after planned surgery is not clear. The aim of this systematic review and meta-analysis is to determine the effect of oral antiseptics (chlorhexidine or povidone-iodine) when administered before and after major elective surgery.
Methods: Searches were conducted of the MEDLINE, EMBASE and Cochrane databases. The analysis was performed using the random-effects method and the risk ratio (RR) with 95 % confidence interval (CI).
Results: Of 1114 unique identified articles, perioperative chlorhexidine was administered to patients undergoing elective surgery in four studies. This identified 2265 patients undergoing elective cardiac surgery, of whom 1093 (48.3 %) received perioperative chlorhexidine. Postoperative pneumonia and nosocomial infections were observed in 5.3 and 20.2 % who received chlorhexidine compared to 10.4 and 31.3 % who received a control preparation, respectively. Oral perioperative chlorhexidine significantly reduced the risk of postoperative pneumonia (RR = 0.52; 95 % CI 0.39-0.71; p < 0.01) and overall nosocomial infections (RR = 0.65; 95 % CI 0.52-0.81; p < 0.01), with no effect on in-hospital mortality (RR = 1.01; 95 % CI 0.49-2.09; p = 0.98).
Conclusions: Perioperative oral chlorhexidine significantly decreases the incidence of nosocomial infection and postoperative pneumonia in patients undergoing elective cardiac surgery. There are no randomised controlled studies of this simple and cheap intervention in patients undergoing elective non-cardiac surgery.
Trial Registration: This systematic review was registered with the International prospective register of systematic reviews (PROSPERO). The registration number is CRD42015016063.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4802585 | PMC |
http://dx.doi.org/10.1186/s13741-016-0030-7 | DOI Listing |
Eur J Med Res
December 2024
Department of Cardiology, Xinqiao Hospital, Army Military Medical University, No. 83 Xinqiao Street, Shapingba District, Chongqing, 400037, China.
Background: Sodium-glucose cotransporter-2 inhibitors (SGLT2i) have been proven to prevent decline in kidney function and failure. Whether SGLT2i affect the risk of contrast-associated acute kidney injury (CA-AKI) remains uncertain.
Methods: Use of SGLT2i was assessed in consecutive diabetics undergoing coronary angiography (CA) or percutaneous coronary intervention (PCI) from January 2020 to May 2023 at a tertiary hospital in Chongqing, China.
J Med Case Rep
December 2024
Department of Neurology, Los Angeles General Medical Center/University of Southern California, 1100 N. State St., Clinic Tower A4E, Los Angeles, CA, 90034, USA.
Background: The sunken flap or sinking skin flap syndrome is a complication that can be observed following decompressive craniectomy. More rare, sinking skin flap syndrome can occur as an iatrogenic complication of pleural effusion evacuation via chest tube placement in the presence of ventriculopleural shunt.
Case Presentation: We report the case of a Hispanic male patient in his 20s who presented to the emergency department after sustaining a penetrating gunshot wound to the head.
BMC Public Health
December 2024
Department of Health Statistics, School of Public Health, The Fourth Military Medical University, Xi'an, 710032, China.
Background: Adverse effects during chemotherapy severely impact the daily diet of breast cancer (BC) patients. Engaging in dietary self-management is crucial for healthy lifestyle and recovery. This study aims to create the Dietary Self-management Behavior Questionnaire (DSMBQ) and preliminarily validate its reliability, validity, and discriminative ability for BC patients undergoing chemotherapy.
View Article and Find Full Text PDFBMC Med Inform Decis Mak
December 2024
Department of Cardiology, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China.
Background: Psychological disorders, such as anxiety and depression, are considered to be one of the causes of noncardiac chest pain (NCCP). And these patients can be challenging to differentiate from coronary artery disease (CAD), leading to a considerable number of patients still undergoing angiography. We aim to develop a practical prediction model and nomogram using cardiopulmonary exercise testing (CPET), to help identify these patients.
View Article and Find Full Text PDFRespir Res
December 2024
Department of Pulmonary Medicine, University Medical Center Essen, Ruhrlandklinik, Essen, Germany.
Background: Using primary airway epithelial cells (AEC) is essential to mimic more closely different types and stages of lung disease in humans while reducing or even replacing animal experiments. Access to lung tissue remains limited because these samples are generally obtained from patients who undergo lung transplantation for end-stage lung disease or thoracic surgery for (mostly) lung cancer. We investigated whether forceps or cryo biopsies are a viable alternative source of AEC compared to the conventional technique.
View Article and Find Full Text PDFEnter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!