Abstract：
Groin surgical site infections (SSIs) after open revascularization can lead to devastating consequences in patients. As a result, prevention has been crucial in minimizing the rate of SSIs. This review aims to evaluate the current body of literature regarding prevention ,techniques including prophylactic flaps, incision technique, topical antibiotic use, closed-incision negative pressure wound therapy, and adhesive drapes.
This review was conducted and reported in accordance with the PRISMA statement. A systematic review was conducted using the Google Scholar, PubMed, and Cochrane Review databases regarding the five prevention topics. The authors identified 1371 potential studies with 33 studies selected and analyzed after systematic review regarding the five preventative topics.
The primary outcome of interest was how the rate of SSI was affected with each preventative technique. As a result, the recommendations are as follows. We suggest prophylactic flaps be considered in high-risk surgical patients undergoing open arterial exposure of the groin (Grade 2C). We suggest consideration of transverse incisions for open arterial exposure of the groin as a means of SSI prevention (Grade 2C). Given the lack of data regarding topical antibiotics no recommendation can be made regarding its use, we suggest closed-incision negative pressure wound therapy be used in groin surgical incisions at high risk for SSI (Grade 2B). Given the paucity of data regarding adhesive drapes, such as Ioban, no recommendation can be made regarding its use.
This review highlights the effects of various preventative techniques and their potential benefit in the prevention of SSI in the groin. However, there is a glaring deficit in the available data, emphasizing the need for additional robust studies to better delineate their effectiveness and implementation into surgical practice. The use of endovascular techniques continues to increase, thus limiting the number of open arterial procedures and the potential for further studies to be conducted. To provide the high-quality studies needed to better evaluate these prevention techniques, large multi-institutional collaboration will likely be necessary to provide the appropriate number of patients to evaluate true effectiveness.
This review was conducted and reported in accordance with the PRISMA statement. A systematic review was conducted using the Google Scholar, PubMed, and Cochrane Review databases regarding the five prevention topics. The authors identified 1371 potential studies with 33 studies selected and analyzed after systematic review regarding the five preventative topics.
The primary outcome of interest was how the rate of SSI was affected with each preventative technique. As a result, the recommendations are as follows. We suggest prophylactic flaps be considered in high-risk surgical patients undergoing open arterial exposure of the groin (Grade 2C). We suggest consideration of transverse incisions for open arterial exposure of the groin as a means of SSI prevention (Grade 2C). Given the lack of data regarding topical antibiotics no recommendation can be made regarding its use, we suggest closed-incision negative pressure wound therapy be used in groin surgical incisions at high risk for SSI (Grade 2B). Given the paucity of data regarding adhesive drapes, such as Ioban, no recommendation can be made regarding its use.
This review highlights the effects of various preventative techniques and their potential benefit in the prevention of SSI in the groin. However, there is a glaring deficit in the available data, emphasizing the need for additional robust studies to better delineate their effectiveness and implementation into surgical practice. The use of endovascular techniques continues to increase, thus limiting the number of open arterial procedures and the potential for further studies to be conducted. To provide the high-quality studies needed to better evaluate these prevention techniques, large multi-institutional collaboration will likely be necessary to provide the appropriate number of patients to evaluate true effectiveness.
摘要：
目的：开放性血运重建术后腹股沟手术部位感染（SSIs）可导致患者的破坏性后果。因此,预防对于最大限度地降低SSIs的发生率至关重要。这篇综述旨在评估当前有关预防技术的文献，包括：预防性皮瓣，切口技术,局部使用抗生素，方法：本综述是根据系统评价和荟萃分析（PRISMA）声明的首选报告项目进行和报告的。利用谷歌学者©进行了系统的审查，PubMed,和关于五个预防主题的CochraneReview数据库。作者确定了1,371项潜在研究，其中33项研究经过对五个预防性主题的系统回顾后进行了分析。
结果：关注的主要结果是每种预防技术对SSI率的影响。因此,建议是:-我们建议在接受腹股沟开放动脉暴露的高危手术患者中考虑使用预防性皮瓣.[2C级]-我们建议考虑腹股沟开放动脉暴露的横切口作为预防SSI的手段。[2C级]-鉴于缺乏关于局部抗生素的数据，无法就其使用提出建议。-我们建议在SSI高风险的腹股沟手术切口中使用闭合切口负压伤口疗法。[2B级]-鉴于有关粘合窗帘的数据很少，如Ioban®，不能就其使用提出建议。
结论：本综述重点介绍了各种预防技术的作用及其在预防腹股沟SSI中的潜在益处。然而,现有数据存在明显不足,强调需要进行更多可靠的研究,以更好地描述其有效性并将其应用于外科实践.虽然血管内技术的使用继续增加，因此限制了开放动脉手术的数量和进行进一步研究的潜力。为了提供更好地评估这些预防技术所需的高质量研究，大型多机构合作可能是必要的,以提供适当数量的患者来评估真正的有效性.
结果：关注的主要结果是每种预防技术对SSI率的影响。
结论：本综述重点介绍了各种预防技术的作用及其在预防腹股沟SSI中的潜在益处。
