Abstract:
No fucking idea. PubMed's link is running some script that causes our entire screen to blink in and out repeatedly and endlessly every time we tried to click into it. After locking up our entire computer three times, we quit trying. We'll be generous, and call that a forfeit, with no decision. If anyone has a link that works, we'll take it, and analyze whatever was there. Otherwise, that's a pass.
We will note this was the most pleasant study we encountered thus far, for not having to wade through it at all.
UPDATE: Having cracked the problem, we went back and looked at this one again.
Abstract:
The Objectives of this study were to critically analyze and systematically review the randomized trials regarding effectiveness of surgical facemasks in preventing post operative wound infection in elective surgery.
Method: Systematic literature review and analysis of all available trials (randomized controlled trials) regarding use of surgical face masks in elective surgeries. Medline (1966-2007), Embase (1996-2007), Cochrane database, Pubmed, Google Scholar, were searched for the selection of literature for the review.
Conclusion: From the limited randomized trials it is still not clear that whether wearing surgical face masks harms or benefit the patients undergoing elective surgery.
Aesop summary of this meta-NON-study: "The dog ate my homework. We studied nothing, and therefore reach no conclusions about masks. Do WhateverTheFuck you want. We're stumped. Now where's my research grant check?"
Applicability of this link to the utility of masks preventing infection by aerosolized viral disease: nil.
11) Use of face masks by non-scrubbed operating room staff: a randomized control trial
Abstract:
Sigh. This one, sadly, works.
Background: Ambiguity remains about the effectiveness of wearing surgical face masks. The purpose of this study was to assess the impact on surgical site infections (SSIs) when non-scrubbed operating room staff did not wear surgical face masks.
Methods: Eight hundred twenty-seven participants undergoing elective or emergency obstetric, gynecological, general, orthopaedic, breast or urological surgery in an Australian tertiary hospital were enrolled. Complete follow-up data were available for 811 patients (98.1%). Operating room lists were randomly allocated to a 'Mask group' (all non-scrubbed staff wore a mask) or 'No Mask group' (none of the non-scrubbed staff wore masks). The primary end point, SSI was identified using in-patient surveillance; post discharge follow-up and chart reviews. The patient was followed for up to six weeks.
Results: Overall, 83 (10.2%) surgical site infections were recorded; 46/401 (11.5%) in the Masked group and 37/410 (9.0%) in the No Mask group; odds ratio (OR) 0.77 (95% confidence interval (CI) 0.49 to 1.21), p = 0.151. Independent risk factors for surgical site infection included: any pre-operative stay (adjusted odds ratio [aOR], 0.43 (95% CI, 0.20; 0.95), high BMI aOR, 0.38 (95% CI, 0.17; 0.87), and any previous surgical site infection aOR, 0.40 (95% CI, 0.17; 0.89).
Conclusion: Surgical site infection rates did not increase when non-scrubbed operating room personnel did not wear a face mask.
Aesop summary: Statistically large sample (>1500 would have been better) group was followed. Miniscule difference in infection rates noted in non-masked vs masked groups. Conclusion: accurate for data looked at.
Gaping holes: A) What types of surgical site infections occurred? B) What were the source bacteria? C) Are any of these bacteria frequently or solely sourced to oral mucosal transmission, or not? D) How many non-scrubbed personnel entered the surgeries in either group (masked or unmasked)? E) Did that number differ between the groups to a significant amount? F) Were surgeries randomly assigned to operating room lists, or were more major surgeries done in certain rooms routinely, thus invalidating "randomized" assignment of masks/non-masks?
IOW: If you're getting non-oral-sourced wound infections, but studying masking, you're looking at whether wearing seat belts or not causes flat tires. I.E. you're a fucktard, with delusions of competence. Welcome to >90% of all peer-reviewed medical "research". If you design an incompetent study, you'll get bullshit. QED. I, you, and the entire medical community have no way to know in this case, as it's not specified. If it was known, they'd have not only documented this fact, they'd have cock-a-doodle-dooed to high heaven. "If you didn't chart it, it didn't happen."
They'd also have to do follow-on studies to explain why masking creates more infections, every time it's studied. This is akin to why Biden wins every time Republicans aren't watching the count.
"Once is happenstance, twice is coincidence, and three times is enemy action." -Ian Fleming
Applicability to masks stopping aerosolized virus transmission: Nil.
At 0 for 10, now out of 50 studies, Nurse Claire's max possible grade is a C+. If she aces every one left, contrary to all preceding performance. Speaking of Aces,
12) Disposable surgical face masks for preventing surgical wound infection in clean surgery
Abstract:
Background: Surgical face masks were originally developed to contain and filter droplets containing microorganisms expelled from the mouth and nasopharynx of healthcare workers during surgery, thereby providing protection for the patient. However, there are several ways in which surgical face masks could potentially contribute to contamination of the surgical wound, e.g. by incorrect wear or by leaking air from the side of the mask due to poor string tension.
Objectives: To determine whether disposable surgical face masks worn by the surgical team during clean surgery prevent postoperative surgical wound infection.
Search methods: We searched The Cochrane Wounds Group Specialised Register on 23 October 2013; The Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library); Ovid MEDLINE; Ovid MEDLINE (In-Process & Other Non-Indexed Citations); Ovid EMBASE; and EBSCO CINAHL.
Selection criteria: Randomised controlled trials (RCTs) and quasi-randomised controlled trials comparing the use of disposable surgical masks with the use of no mask.
Data collection and analysis: Two review authors extracted data independently.
Main results: Three trials were included, involving a total of 2113 participants. There was no statistically significant difference in infection rates between the masked and unmasked group in any of the trials.
Authors' conclusions: From the limited results it is unclear whether the wearing of surgical face masks by members of the surgical team has any impact on surgical wound infection rates for patients undergoing clean surgery.
Aesop summary: In what is sure to be a mind-blowing epiphany to countless Anonymous Jackholes on the internet, allow us to quote the opening factoid from of the abstract, appropriately highlighted:
"Surgical face masks were originally developed to contain and filter droplets containing microorganisms expelled from the mouth and nasopharynx of healthcare workers during surgery, thereby providing protection for the patient."
If this was news to you, go back and re-read that last block of text until it penetrates your cranium, and occupies space in your brain alongside the sure and certain knowledge that 2+2=4.
That said, this study is no such thing. It's merely another meta-study of other people's work, and summarizing the results.
Which told them...wait for it...nothing of any clinical significance.
Applicability to masks stopping aerosolized virus propagation: Nil.
13) Same title and meta-NON-study as #12, two years later
SS,DD
___
Medical Studies You'll Never Find Dept.: A study showing what percentage of post-operative surgical wound infections are directly traceable to oral-pharyngeal-sourced infectious bacteria.
Because if the answer were to be found to be either statistically insignificant, or zero, the question of masks in surgery to protect the patient would disappear.
(At least it would, until someone caught a cold or other URI, and sued the surgery team for not wearing masks during surgery.)
It wouldn't make the risks of surgical team members cross-contaminating their surgical co-workers with their URIs go away.
It wouldn't make the question of participant protection from wound splatter (and if you haven't seen a bone saw used in surgery, or seen an arterial vessel rupture, in person, you can STFU on the entire topic) go away either.
Which is why some form of masks in surgery aren't going away in your lifetime. And shouldn't. They may transmogrify into full-face shields, or PAPR hoods, or something similar, but they're not going away. Probably not EVER.
So one has to wonder, knowing that obvious answer, why the quest to study mask effectiveness in preventing patient infections, if that problem has been overtaken by the invention of prophylactic antibiotics after surgery, among many other reasons.
Masks in surgery is like "medical marijuana": it's the camel's nose under the tent flap. Agenda-driven nonsense by people who should know better, mainly to justify their desire for their own laziness.
Most of the studies thus far date to when infection by blood-borne pathogens were documented and well-known. So there ain't no one who's going into surgery (with half a functioning brain) without covering up as much of themselves as they can when blood and body fluids are liable to be flying around unhindered.
Anyone pushing for eliminating that is pretty much a stupid bastard, and a lazy moron, simultaneously. And no small number have medical and nursing licenses. Do try to bear that well in mind as we hack our way through the other 39 links in this inane series of fail.
Team Claire: 0.000 batting average to date. 13 worthless studies. Max possible score remaining: 76%.
No comments:
Post a Comment