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Abstract：
Surgical site infections (SSIs) following major lower limb amputation (MLLA) in vascular patients are a major source of morbidity. The objective of this systematic review was to determine the incidence of SSI following MLLA in vascular patients. This review was prospectively registered with the International Prospective Register of Systematic Reviews (CRD42023460645). Databases were searched without date restriction using a pre-defined search strategy. The search identified 1427 articles. Four RCTs and 21 observational studies, reporting on 50 370 MLLAs, were included. Overall SSI incidence per MLLA incision was 7.2% (3628/50370). The incidence of SSI in patients undergoing through-knee amputation (12.9%) and below-knee amputation (7.5%) was higher than the incidence of SSI in patients undergoing above-knee amputation, (3.9%), p < 0.001. The incidence of SSI in studies focusing on patients with peripheral arterial disease (PAD), diabetes or including patients with both was 8.9%, 6.8% and 7.2%, respectively. SSI is a common complication following MLLA in vascular patients. There is a higher incidence of SSI associated with more distal amputation levels. The reported SSI incidence is similar between patients with underlying PAD and diabetes. Further studies are needed to understand the exact incidence of SSI in vascular patients and the factors which influence this.
摘要：
血管患者下肢严重截肢（MLLA）后的手术部位感染（SSIs）是发病率的主要来源。这项系统评价的目的是确定血管患者MLLA后SSI的发生率。该综述在国际前瞻性系统评价登记册（CRD42023460645）中进行了前瞻性注册。使用预定义的搜索策略在没有日期限制的情况下搜索数据库。搜索确定了1427篇文章。四项随机对照试验和21项观察性研究，报告了50370个MLLA，包括在内。每个MLLA切口的总SSI发生率为7.2%(3628/50370)。经膝截肢(12.9%)和膝下截肢(7.5%)患者的SSI发生率高于膝上截肢患者的SSI发生率,（3.9%），p<0.001。在关注外周动脉疾病（PAD）患者的研究中，SSI的发生率糖尿病或包括两者的患者为8.9％，6.8%和7.2%，分别。SSI是血管患者MLLA后的常见并发症。与远端截肢水平相关的SSI发生率较高。报告的SSI发生率在患有基础PAD和糖尿病的患者之间相似。需要进一步的研究来了解血管患者SSI的确切发生率及其影响因素。
