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Author Credentials

Kumar, KJ1*,Smith, Z1

  1. Adelaide Nursing School, Faculty of Health and Medical Sciences, The University of Adelaide, SA, Australia

*Corresponding Author

Kumar, KJ1*

RN, DN, BN, MNSc

Student

Adelaide Nursing School, Faculty of Health and Medical Sciences, The University of Adelaide, SA, Australia

kritika.kumar@student.adelaide.edu.au

ORCID: Kritika Jyoti Kumar https://orcid.org/0009-0007-4770-1313

Dr. Smith, Z1

RN, BN, PGDip (Clin Prac-Periop), MClin Prac with Distinction, MTerEd Mgmt, PhD, FACORN

Senior Lecture Nursing

Adelaide Nursing School, Faculty of Health and Medical Sciences, The University of Adelaide, SA, Australia

zaneta.smith@adelaide.edu.au

ORCID: Dr Zaneta Smith https://orcid.org/0000-0002-5575-1165

Abstract

Aim: To evaluate and synthesise the effectiveness of intra-operative gentamicin in reducing post-operative surgical site infections compared to other irrigating solutions or no irrigation.

Background: Surgical site infection has posed challenges to health care providers around the globe. It is influenced by many risk factors, only a few of which are under the control of the surgeon and operating team. Wound irrigation is considered an essential part of the intra-operative process. It aims to minimise the risk of surgical site infection by thorough lavage of the operative site.

Design: Systematic review of effectiveness.

Review methods: The databases CINAHL, Scopus, Embase, Medline, PubMed, OpenGrey, Google Scholar and ProQuest Dissertations & Theses Global were searched with parameters set between 1 January 2013 and 31 July 2023. The review followed the Joanna Briggs Institute (JBI) methodology for systematic reviews of effectiveness and the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA 2020) guidelines. Two independent reviewers conducted the selection process, critical appraisal and data extraction. The eligible studies were critically appraised using JBI critical appraisal tools for randomised controlled trials and cohort studies. Data synthesis was performed through subgroup analysis and narrative synthesis, since meta-analysis was not possible.

Results: The impact of intra-operative gentamicin irrigation on surgical site infections was analysed across eight studies. The subgroup analysis favoured the gentamicin saline group over the saline group in reducing post-operative surgical site infections (RR=0.27 [0.13;0.55], P < 0.001.)

Conclusion: This systematic review shows that intra-operative gentamicin irrigation lowers the incidence of surgical site infections when compared to normal saline irrigation. However, there were contradictory results when intra-operative gentamicin irrigation was compared to alternative interventions such as no irrigation, diluted povidone iodine and combination antibiotic irrigation.

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Creative Commons Attribution 4.0 License
This work is licensed under a Creative Commons Attribution 4.0 License.

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