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. 2020 Feb:102:103486.
doi: 10.1016/j.ijnurstu.2019.103486. Epub 2019 Nov 22.

Preoperative and postoperative recommendations to surgical wound care interventions: A systematic meta-review of Cochrane reviews

Brigid M Gillespie  1 , Rachel M Walker  2 , Elizabeth McInnes  3 , Zena Moore  4 , Anne M Eskes  5 , Tom O'Connor  6 , Emma Harbeck  7 , Codi White  7 , Ian A Scott  8 , Hester Vermeulen  9 , Wendy Chaboyer  7
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Free article

Preoperative and postoperative recommendations to surgical wound care interventions: A systematic meta-review of Cochrane reviews

Brigid M Gillespie et al. Int J Nurs Stud. 2020 Feb.
Free article

Abstract

Background: The increasing numbers of surgeries involving high risk, multi-morbid patients, coupled with inconsistencies in the practice of perioperative surgical wound care, increases patients' risk of surgical site infection and other wound complications.

Objectives: To synthesise and evaluate the recommendations for nursing practice and research from published systematic reviews in the Cochrane Library on nurse-led preoperative prophylaxis and postoperative surgical wound care interventions used or initiated by nurses.

Design: Meta-review, guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.

Data sources: The Cochrane Library database.

Review methods: All Cochrane Systematic Reviews were eligible. Two reviewers independently selected the reviews and extracted data. One reviewer appraised the methodological quality of the included reviews using A MeaSurement Tool to Assess Systematic Reviews 2 checklist. A second reviewer independently verified these appraisals. The review protocol was registered with the Prospective Register of Systematic Reviews.

Results: Twenty-two Cochrane reviews met the inclusion criteria. Of these, 11 reviews focused on preoperative interventions to prevent infection, while 12 focused on postoperative interventions (one review assessed both pre-postoperative interventions). Across all reviews, 14 (63.6%) made at least one recommendation to undertake a specific practice, while two reviews (9.1%) made at least one specific recommendation not to undertake a practice. In relation to recommendations for further research, insufficient sample size was the most predominant methodological issue (12/22) identified across reviews.

Conclusions: The limited number of recommendations for pre-and-postoperative interventions reflects the paucity of high-quality evidence, suggesting a need for rigorous trials to address these evidence gaps in fundamentals of nursing care.

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