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Abstract：
OBJECTIVE: By reviewing the literature analyzing vancomycin powder for preventive surgery, the effect of this method on reducing the infection rate after TJA was systematically evaluated to provide a basis for future clinical work.
METHODS: Using PubMed, Medline, Elsevier, and CNKI, with the following mesh words: \"vancomycin\", \"local / intraoperative / topical / intrawound\", \"TJA\", \"TKA\", \"THA\", \"total joint arthroplasty\", \"total knee arthroplasty\", \"total hip arthroplasty\", \"infection\", and \"SSI\", to search for case-control research papers on the impact of prophylactic application of vancomycin powder on the incidence of postoperative infection, we compared the overall infection rate in the literature by using RevMan 5.3 meta-analysis software and analyzed the impact of vancomycin on the infection rate of different parts and types of TJA according to different subgroups.
RESULTS: A total of 22 qualified studies were selected; twenty-five studies compared the effect of prophylactic use of vancomycin powder on infection rates after TJA. There were 23,363 cases in total, including 9545 cases in the vancomycin group and 13,818 cases in the control group. The results of the meta-analysis showed that the possibility of postoperative infection after prophylactic use of vancomycin powder was significantly lower than that without vancomycin risk ratio: 0.38 [0.23,0.59], P < 0.01). However, a meta-analysis of randomized controlled trials (RCTs) showed no significant effect of vancomycin on postoperative infection (P = 0.52).
CONCLUSIONS: Based on the retrospective studies, local prophylactic use of vancomycin powder in TJA can significantly reduce the incidence of postoperative infection. High-quality RCTs should be carried out to further evaluate these results.
METHODS: Using PubMed, Medline, Elsevier, and CNKI, with the following mesh words: \"vancomycin\", \"local / intraoperative / topical / intrawound\", \"TJA\", \"TKA\", \"THA\", \"total joint arthroplasty\", \"total knee arthroplasty\", \"total hip arthroplasty\", \"infection\", and \"SSI\", to search for case-control research papers on the impact of prophylactic application of vancomycin powder on the incidence of postoperative infection, we compared the overall infection rate in the literature by using RevMan 5.3 meta-analysis software and analyzed the impact of vancomycin on the infection rate of different parts and types of TJA according to different subgroups.
RESULTS: A total of 22 qualified studies were selected; twenty-five studies compared the effect of prophylactic use of vancomycin powder on infection rates after TJA. There were 23,363 cases in total, including 9545 cases in the vancomycin group and 13,818 cases in the control group. The results of the meta-analysis showed that the possibility of postoperative infection after prophylactic use of vancomycin powder was significantly lower than that without vancomycin risk ratio: 0.38 [0.23,0.59], P < 0.01). However, a meta-analysis of randomized controlled trials (RCTs) showed no significant effect of vancomycin on postoperative infection (P = 0.52).
CONCLUSIONS: Based on the retrospective studies, local prophylactic use of vancomycin powder in TJA can significantly reduce the incidence of postoperative infection. High-quality RCTs should be carried out to further evaluate these results.
摘要：
目的：通过对万古霉素散用于预防性手术的文献分析，系统评价该方法对降低TJA术后感染率的效果,为今后的临床工作提供依据。
方法：使用PubMed，Medline,Elsevier,和CNKI，带有以下网格单词：“万古霉素”，“局部/术中/局部/伤口内”，\"TJA\",\"TKA\",\"THA\",“全关节置换术”，“全膝关节置换术”，“全髋关节置换术”，\"感染\",和“SSI”，寻找预防性应用万古霉素粉对术后感染发生率影响的病例对照研究论文，采用RevMan5.3meta分析软件对文献中总感染率进行比较,并根据不同亚组分析万古霉素对不同部位、不同类型TJA感染率的影响。
结果：共选择了22项合格研究；25项研究比较了预防性使用万古霉素粉对TJA后感染率的影响。共有23363例,万古霉素组9545例,对照组13818例。meta分析结果显示,预防性使用万古霉素粉后发生术后感染的可能性明显低于不使用万古霉素的风险比:0.38[0.23,0.59],P<0.01)。然而,一项随机对照试验(RCTs)的荟萃分析显示,万古霉素对术后感染无显著影响(P=0.52).
结论：基于回顾性研究，TJA局部预防性使用万古霉素粉剂可显著降低术后感染的发生率。应进行高质量的RCT以进一步评估这些结果。
方法：使用PubMed，Medline,Elsevier,和CNKI，带有以下网格单词：“万古霉素”，“局部/术中/局部/伤口内”，\"TJA\",\"TKA\",\"THA\",“全关节置换术”，“全膝关节置换术”，“全髋关节置换术”，\"感染\",和“SSI”，寻找预防性应用万古霉素粉对术后感染发生率影响的病例对照研究论文，采用RevMan5.3meta分析软件对文献中总感染率进行比较,并根据不同亚组分析万古霉素对不同部位、不同类型TJA感染率的影响。
结果：共选择了22项合格研究；25项研究比较了预防性使用万古霉素粉对TJA后感染率的影响。共有23363例,万古霉素组9545例,对照组13818例。meta分析结果显示,预防性使用万古霉素粉后发生术后感染的可能性明显低于不使用万古霉素的风险比:0.38[0.23,0.59],P<0.01)。然而,一项随机对照试验(RCTs)的荟萃分析显示,万古霉素对术后感染无显著影响(P=0.52).
结论：基于回顾性研究，TJA局部预防性使用万古霉素粉剂可显著降低术后感染的发生率。应进行高质量的RCT以进一步评估这些结果。
