Abstract | CONTEXT: While the main focus of a meta-analysis is often to assess the effectiveness of a particular intervention in managing or curing a specific condition, there exists a substantial amount of information within published systematic reviews that could be used to assess the validity of a generic hypothesis about the effectiveness of an intervention across a range of different but related conditions. OBJECTIVE: DATA SOURCES: Medline and the Cochrane Database of Systematic Reviews. STUDY SELECTION: DATA EXTRACTION: Independent data extraction by multiple observers. RESULTS: The first hypothesis was strongly supported by the data as evidenced by the fact that the estimates of the relative risk of infection for the 23 types of surgery that were included in the study were all less than 1. However, there was no real evidence supporting the second hypothesis that the relative risk of wound infection would substantially vary over different levels of surgery cleanliness. CONCLUSION: : As well as antibiotic prophylaxis being a generally effective intervention for preventing postoperative wound infection, the level of this effectiveness would appear to be reasonably independent of what type of surgery is being considered. Therefore, the general prevailing attitude that antibiotic prophylaxis should be assumed to be ineffective unless its effectiveness has been experimentally proven beyond doubt for the specific type of surgery being considered, perhaps should be revised. In particular, perhaps a sensible philosophy would be to assume that antibiotic prophylaxis is effective in reducing the risk of wound infection for all types of surgery, even ones where no clinical trial data exists and make exceptions to this rule if, for certain types of surgery, it can be proved to the contrary.
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Authors | Russell J Bowater, Seonaid A Stirling, Richard J Lilford |
Journal | Annals of surgery
(Ann Surg)
Vol. 249
Issue 4
Pg. 551-6
(Apr 2009)
ISSN: 1528-1140 [Electronic] United States |
PMID | 19300236
(Publication Type: Comparative Study, Journal Article, Meta-Analysis, Research Support, Non-U.S. Gov't, Review)
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Chemical References |
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Topics |
- Anti-Bacterial Agents
(administration & dosage)
- Antibiotic Prophylaxis
(standards, trends)
- Female
- Humans
- Incidence
- Male
- Preoperative Care
(methods)
- Randomized Controlled Trials as Topic
- Risk Assessment
- Sensitivity and Specificity
- Surgical Procedures, Operative
(adverse effects, methods)
- Surgical Wound Infection
(epidemiology, prevention & control)
- Treatment Outcome
- Wound Healing
(drug effects, physiology)
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