ArticlePerioperative medicine (London, England)2016
A systematic review and meta-analysis of perioperative oral decontamination in patients undergoing major elective surgery.
Article in Perioperative medicine (London, England), 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers, 3 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
18 citing papers in PubMed, 3 syntheses or guidelines pooled it, 49 citations in OpenAlex.
- Effect of perioperative oral care on postoperative pneumonia in thoracic surgery patients: a systematic review and meta-analysis.Scientific reports · 2025Pooled it
- Effectiveness of chlorhexidine in preventing infections among patients undergoing cardiac surgeries: a meta-analysis and systematic review.Antimicrobial resistance and infection control · 2021Pooled it
- An umbrella review of systematic reviews of the evidence of a causal relationship between periodontal microbes and respiratory diseases: Position paper from the Canadian Dental Hygienists Association.Canadian journal of dental hygiene : CJDH = Journal canadien de l'hygiene dentaire : JCHD · 2020Pooled it
- Patient-reported outcome measures comparing povidone iodine rinse and chlorhexidine rinse for dental implant therapy: a randomized controlled trial.BMC oral health · 2025Trial
- Oropharyngeal and nasopharyngeal decontamination with chlorhexidine gluconate in lung cancer surgery: a randomized clinical trial.Intensive care medicine · 2018Trial
- Article
- Impact of oral/dental disease burden on postoperative infective complications: a prospective cohort study.Clinical oral investigations · 2023Article
- Difficult intubation and postoperative aspiration pneumonia associated with Moebius syndrome: a case report.BMC anesthesiology · 2022Article
- A practical guide for perioperative smoking cessation.Journal of anesthesia · 2022Review
- Attitudes towards Antibiotic Prescription and Antimicrobial Resistance Awareness among Italian Dentists: What Are the Milestones?Healthcare (Basel, Switzerland) · 2022Article
- De-adoption of oral chlorhexidine for mechanically ventilated patients: get thee to a conclusion.Acute and critical care · 2022Article
- Article
- Article
- Clinical impact of periodontal disease on postoperative complications in gastrointestinal cancer patients.International journal of clinical oncology · 2019Article
- Association between perioperative oral care and postoperative pneumonia after cancer resection: conventional versus high-dimensional propensity score matching analysis.Clinical oral investigations · 2019Article
- What are the optimum components in a care bundle aimed at reducing post-operative pulmonary complications in high-risk patients?Perioperative medicine (London, England) · 2018Article
- Oral care with chlorhexidine seems effective for reducing the incidence of ventilator-associated pneumonia.Evidence-based dentistry · 2017Article
- Effect of oral care protocol with versus without chlorhexidine on mortality of mechanically ventilated patients: Prospective randomized controlled trial.Journal of anaesthesiology, clinical pharmacologyArticle
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
9 authors at 4 institutions in 1 country.
Funding
Abstract
backgroundOral antiseptics reduce nosocomial infections and ventilator-associated pneumonia in critically ill medical and surgical patients intubated for prolonged periods. However, the role of oral antiseptics given before and after planned surgery is not clear. The aim of this systematic review and meta-analysis is to determine the effect of oral antiseptics (chlorhexidine or povidone-iodine) when administered before and after major elective surgery.
methodsSearches were conducted of the MEDLINE, EMBASE and Cochrane databases. The analysis was performed using the random-effects method and the risk ratio (RR) with 95 % confidence interval (CI).
resultsOf 1114 unique identified articles, perioperative chlorhexidine was administered to patients undergoing elective surgery in four studies. This identified 2265 patients undergoing elective cardiac surgery, of whom 1093 (48.3 %) received perioperative chlorhexidine. Postoperative pneumonia and nosocomial infections were observed in 5.3 and 20.2 % who received chlorhexidine compared to 10.4 and 31.3 % who received a control preparation, respectively. Oral perioperative chlorhexidine significantly reduced the risk of postoperative pneumonia (RR = 0.52; 95 % CI 0.39-0.71; p < 0.01) and overall nosocomial infections (RR = 0.65; 95 % CI 0.52-0.81; p < 0.01), with no effect on in-hospital mortality (RR = 1.01; 95 % CI 0.49-2.09; p = 0.98).
conclusionsPerioperative oral chlorhexidine significantly decreases the incidence of nosocomial infection and postoperative pneumonia in patients undergoing elective cardiac surgery. There are no randomised controlled studies of this simple and cheap intervention in patients undergoing elective non-cardiac surgery.
trial registrationThis systematic review was registered with the International prospective register of systematic reviews (PROSPERO). The registration number is CRD42015016063.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.