17 September 2024 : Original article
Preoperative Evidence-Based Practice for Prevention of Early Postoperative Infections in Patients Receiving a Liver Transplant
Dong-Xia Wu1AFG, Jing-Xian Hu2AF, Xiu-Lian Wu1AF, Jia-Ning Han1B, Ke-Yi Chang1C, Xiao-Li Quan1DE, Shuang-Mei Xi2AB, Xiao-Lan Wang2DE, Hui-Min Guo2DE, Li-Li Zhang2AEG*DOI: 10.12659/AOT.943610
Ann Transplant 2024; 29:e943610
Table 1 Evidence translation quality appraisal table.
| Evidence | Review indicators | Review methods |
|---|---|---|
| 1. It is a good clinical practice to give patients a bath or shower before surgery. The expert panel suggests that for this purpose, regular soap or antibacterial soap can be used (conditionally recommended, moderate quality evidence) []16 | 1. The nurse instructs liver transplant patients to shower with regular soap the day before surgery | View nursing records |
| 2. The night before (or earlier) the day of surgery, patients should take a shower or full-body bath using antibacterial/non-antibacterial soap or other antibacterial agents (conditionally recommended, moderate quality evidence) []16 | 2. Routine preparation does not include shaving for patients preparing for surgery; if excessive body hair affects surgical visibility, it can only be removed with scissors | View nursing records |
| 3. It is not recommended to remove hair from patients preparing for surgery. If necessary, only scissors should be used to remove hair. Whether it is before surgery or in the operating room, the use of razors to remove hair is strongly discouraged (strongly recommended, moderate quality evidence) []16 | 3. Prophylactic antibiotics are administered within 120 minutes prior to surgery | View nursing records |
| 4. It is recommended to prophylactically use antibiotics when necessary before surgical incision []16 | 4. Patients with low body weight, specifically a BMI below 18.5, are given oral or nasal nutrition solutions | View the record sheet |
| 5. It is recommended to administer prophylactic antibiotics within 120 minutes before surgical incision. However, consideration should also be given to the half-life of the antibiotic []16 | 5. For patients with high-risk factors prior to surgery, nurses guide them in performing pulmonary | Lung function exercise record sheet |
| 6. Underweight patients undergoing major surgery are recommended to receive oral or enteral nutrition containing a variety of nutrients to prevent surgical site infections (SSI) []15 | 6. Specific plan for pulmonary function exercises | Check the medical orders and nursing records |
| 7. ”Underweight” refers to individuals with a weight that is below healthy standards. This definition typically applies to individuals with a body mass index (BMI) below 18.5, or individuals whose weight is 15–20% below the normal range for their age and height []15 | 7. Prior to surgery, doctors use the national organ procurement standards to conduct infection risk screening for organ donors | |
| 8. One of the important components of Enhanced Recovery After Surgery (ERAS) is airway management, which, when applied in clinical practice, can reduce pulmonary complications []25 | ||
| 9. Preoperative pulmonary rehabilitation training can reduce the occurrence of postoperative complications []25 | ||
| 10. Common high-risk factors in patients prior to surgery include: Advanced age: Age ≥65 years (if combined with smoking, males aged >60 years and females aged >70 years are considered advanced age). Long-term heavy smoking (smoking history ≥400 pack-years). Tracheal colonization with bacteria. Airway hyperresponsiveness. Peak expiratory flow (PEF) <250 L/min. Marginal lung function, requiring pulmonary function exercise []25 | ||
| 11. Specific pulmonary function exercise program. | ||
| 12. Potential infections carried by organ transplant donors, known as donor-derived infections, require a careful evaluation of the potential infection risk in organ donors[]25 | ||
| 13. Organ donors were screened for the risk of infection according to the national organ procurement criteria (false positive and false negative risk) (BIII) [,]17 | ||
| Evidence 1 and 2 correspond to review index 1; evidence 3 corresponds to review index 2; evidence 4 and 5 correspond to review index 3; evidence 6 and 7 correspond to review index 4; evidence 8,9 and 10 correspond to review index 5; evidence 11 corresponds to review index 6; evidence 12 and 13 should review index 7. | ||