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id="_NBK561387_"><span itemprop="name">Evidence review for wound lavage</span></h1><div class="subtitle">Joint replacement (primary): hip, knee and shoulder</div><p><b>Evidence review H</b></p><p><i>NICE Guideline, No. 157</i></p><p class="contrib-group"><h4>Authors</h4><span itemprop="author">National Guideline Centre (UK)</span>.</p><div class="half_rhythm">London: <a href="https://www.nice.org.uk" ref="pagearea=meta&targetsite=external&targetcat=link&targettype=publisher"><span itemprop="publisher">National Institute for Health and Care Excellence (NICE)</span></a>; <span itemprop="datePublished">2020 Jun</span>.<div class="small">ISBN-13: <span itemprop="isbn">978-1-4731-3722-6</span></div></div><div><a href="/books/about/copyright/">Copyright</a> © NICE 2020.</div></div><div class="bkr_clear"></div></div><div id="niceng157er8.s1"><h2 id="_niceng157er8_s1_">1. Wound lavage</h2><div id="niceng157er8.s1.1"><h3>1.1. Review question: In adults having primary elective joint replacement, what is the clinical and cost effectiveness of antibiotic or antiseptic wound lavage during the procedure?</h3></div><div id="niceng157er8.s1.2"><h3>1.2. Introduction</h3><p>Wound lavage or irrigation is a washout process routinely used during surgery when performing hip, knee and shoulder replacements. It is used to remove contamination and debris from the site of an operation during the procedure. It is seen as a key part of joint replacement surgery.</p><p>In so doing this enables:
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<dl class="temp-labeled-list"><dl class="bkr_refwrap"><dt>1)</dt><dd><p class="no_top_margin">the clinician to have a clear view of the site.</p></dd></dl><dl class="bkr_refwrap"><dt>2)</dt><dd><p class="no_top_margin">the exposure and preparation of bone surfaces - allowing the adhesive cement, used in the procedure, to penetrate the bone enabling a solid and lasting fix (of the implant).</p></dd></dl><dl class="bkr_refwrap"><dt>3)</dt><dd><p class="no_top_margin">the removal of debris that, potentially, might pass into the blood stream and so to another site in the body.</p></dd></dl><dl class="bkr_refwrap"><dt>4)</dt><dd><p class="no_top_margin">a reduction in microbial contamination of the operative site, potentially reducing infection.</p></dd></dl></dl>
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</p><p>The solution used to washout the area of surgery during joint replacement surgery varies; usually influenced by the surgeon’s preference: normal saline, an antiseptic solution or a solution containing antibiotics can be used. However, what is not known is whether the addition of antibiotics and/or antiseptic solutions to the wound lavage fluid help to reduce the risk of infection more effectively than using wound lavage with normal saline solution, alone.</p><p>This review focuses on whether antiseptic and/or antibiotic components, when added to the irrigation fluid, are clinically and cost effective when compared to irrigation with saline alone.</p></div><div id="niceng157er8.s1.3"><h3>1.3. PICO table</h3><p>For full details, see the review protocol in <a href="#niceng157er8.appa">Appendix A</a>:</p><div class="iconblock whole_rhythm clearfix ten_col table-wrap" id="figniceng157er8tab1"><a href="/books/NBK561387/table/niceng157er8.tab1/?report=objectonly" target="object" title="Table 1" class="img_link icnblk_img figpopup" rid-figpopup="figniceng157er8tab1" rid-ob="figobniceng157er8tab1"><img class="small-thumb" src="/books/NBK561387/table/niceng157er8.tab1/?report=thumb" src-large="/books/NBK561387/table/niceng157er8.tab1/?report=previmg" alt="Table 1. PICO characteristics of review question." /></a><div class="icnblk_cntnt"><h4 id="niceng157er8.tab1"><a href="/books/NBK561387/table/niceng157er8.tab1/?report=objectonly" target="object" rid-ob="figobniceng157er8tab1">Table 1</a></h4><p class="float-caption no_bottom_margin">PICO characteristics of review question. </p></div></div></div><div id="niceng157er8.s1.4"><h3>1.4. Clinical evidence</h3><div id="niceng157er8.s1.4.1"><h4>1.4.1. Included studies</h4><p>No relevant clinical studies were identified comparing saline wound lavage with an additional antiseptic and/or antibiotic agent to saline wound lavage without additional agent in adults having primary elective joint replacement. The searches looked for both RCTs and also non-randomised studies.</p><p>See also the study selection flow chart in <a href="#niceng157er8.appc">Appendix C</a>:</p></div><div id="niceng157er8.s1.4.2"><h4>1.4.2. Excluded studies</h4><p>See the excluded studies list in <a href="#niceng157er8.appe">Appendix E</a>:</p></div></div><div id="niceng157er8.s1.5"><h3>1.5. Economic evidence</h3><div id="niceng157er8.s1.5.1"><h4>1.5.1. Included studies</h4><p>No relevant health economic studies were identified.</p></div><div id="niceng157er8.s1.5.2"><h4>1.5.2. Excluded studies</h4><p>No health economic studies that were relevant to this question were excluded due to assessment of limited applicability or methodological limitations.</p></div><div id="niceng157er8.s1.5.3"><h4>1.5.3. Unit costs</h4><p>Relevant unit costs are provided below to aid consideration of cost effectiveness.</p><div class="iconblock whole_rhythm clearfix ten_col table-wrap" id="figniceng157er8tab2"><a href="/books/NBK561387/table/niceng157er8.tab2/?report=objectonly" target="object" title="Table 2" class="img_link icnblk_img figpopup" rid-figpopup="figniceng157er8tab2" rid-ob="figobniceng157er8tab2"><img class="small-thumb" src="/books/NBK561387/table/niceng157er8.tab2/?report=thumb" src-large="/books/NBK561387/table/niceng157er8.tab2/?report=previmg" alt="Table 2. UK costs for irrigation solution composition." /></a><div class="icnblk_cntnt"><h4 id="niceng157er8.tab2"><a href="/books/NBK561387/table/niceng157er8.tab2/?report=objectonly" target="object" rid-ob="figobniceng157er8tab2">Table 2</a></h4><p class="float-caption no_bottom_margin">UK costs for irrigation solution composition. </p></div></div><div class="iconblock whole_rhythm clearfix ten_col table-wrap" id="figniceng157er8tab3"><a href="/books/NBK561387/table/niceng157er8.tab3/?report=objectonly" target="object" title="Table 3" class="img_link icnblk_img figpopup" rid-figpopup="figniceng157er8tab3" rid-ob="figobniceng157er8tab3"><img class="small-thumb" src="/books/NBK561387/table/niceng157er8.tab3/?report=thumb" src-large="/books/NBK561387/table/niceng157er8.tab3/?report=previmg" alt="Table 3. UK costs for irrigation delivery method." /></a><div class="icnblk_cntnt"><h4 id="niceng157er8.tab3"><a href="/books/NBK561387/table/niceng157er8.tab3/?report=objectonly" target="object" rid-ob="figobniceng157er8tab3">Table 3</a></h4><p class="float-caption no_bottom_margin">UK costs for irrigation delivery method. </p></div></div></div></div><div id="niceng157er8.s1.6"><h3>1.6. Evidence statements</h3><div id="niceng157er8.s1.6.1"><h4>1.6.1. Clinical evidence statements</h4><p>No relevant clinical studies were identified.</p></div><div id="niceng157er8.s1.6.2"><h4>1.6.2. Health economic evidence statements</h4><p>No relevant economic evaluations were identified.</p></div></div><div id="niceng157er8.s1.7"><h3>1.7. The committee’s discussion of the evidence</h3><div id="niceng157er8.s1.7.1"><h4>1.7.1. Interpreting the evidence</h4><div id="niceng157er8.s1.7.1.1"><h5>1.7.1.1. The outcomes that matter most</h5><p>The critical outcomes were agreed to be mortality at 30 days, quality of life (QOL), and superficial and deep surgical site infection. Ultimately this review sought to discover whether wound lavage with antiseptic or antibiotics reduces infections (superficial and deep surgical site) and therefore these were the critical outcomes. Mortality at 30 days and quality of life (QOL) considered were surrogates for infection.</p><p>The important outcomes were return to theatre, allergic reaction, adverse antibiotic reactions, hospital readmission, pain and length of stay.</p></div><div id="niceng157er8.s1.7.1.2"><h5>1.7.1.2. The quality of the evidence</h5><p>No clinical studies relevant to the review question were identified.</p></div><div id="niceng157er8.s1.7.1.3"><h5>1.7.1.3. Benefits and harms</h5><p>Infections after joint replacement surgery are rare, but when they occur, the cost to the person can be very high, and the financial cost to the NHS is significant. Surgical site infection can lead to catastrophic outcomes, in extreme cases it can result in systemic infection and sepsis resulting in death or it can lead to severe local infection that may necessitate amputation of the affected limb.</p><p>The committee discussed how wound lavage/irrigation might reduce surgical site infection. It is thought that a vector of infection is bacteria settling on the wound during surgery and that irrigation of the wound might remove these bacteria and consequently reduces infections. The addition of antibiotics or antiseptics to the irrigation solution has been postulated to increase the anti-infection effect.</p><p>The committee accepted that no evidence was found for this evidence review and there was no consensus amongst the committee that the addition of antibiotics or antiseptics to irrigation solution reduces infections. The committee were also concerned this uncertainly of effectiveness would be combined with the potential negative effect of the agents leading to increase antimicrobial resistance.</p><p>The committee discussed that would lavage is also used to remove debris generated during the preparation of the joint surfaces for surgery. This enables the surgeon to properly see the operative field and accurately undertake the surgery. For cemented implants, as well as preparing the joint surfaces for cementation it helps reduce the risk of cement embolisation syndrome. Thus, irrigation is an established practice that is currently used for more purposes than reduction of surgical site infections.</p><p>The committee were aware of the wound irrigation and intracavity lavage recommendations in Surgical site infections: prevention and treatment NICE guideline (NG125).<a class="bibr" href="#niceng157er8.ref25" rid="niceng157er8.ref25"><sup>25</sup></a> The guideline recommends not using wound irrigation or intracavity lavage to reduce the risk of surgical site infection. The committee agreed that current practice for prevention infection includes giving all people having joint replacement surgery prophylactic antibiotics and doing the surgery in ultra clean-air theatres. With this in mind and because of the lack of evidence the committee agreed to recommend not using antibiotic or antiseptic agents in wound lavage for elective joint replacement.</p></div></div><div id="niceng157er8.s1.7.2"><h4>1.7.2. Cost effectiveness and resource use</h4><p>No economic evaluations were found that matched the protocol. It was discussed that the use of wound lavage is an established part of current practice in joint replacement. The committee noted that saline solution is also used as an irrigation fluid for purposes other than reducing surgical site infection (SSI). Therefore, its use for reducing SSI does not represent an additional cost to a joint replacement operation.</p><p>The addition of antiseptics or antibiotics to the wound lavage would represent an additional cost to wound lavage given that their unit costs are greater. However, the additional cost could be unnecessary given that there was no evidence that the addition of antiseptics or antibiotics reduced SSI.</p><p>The committee decided to cross refer to the NICE guideline NG125 on SSI, which is not expected to have a resource impact.</p></div><div id="niceng157er8.s1.7.3"><h4>1.7.3. Other factors the committee took into account</h4><p>It was acknowledged during the discussions that there would be economic considerations for the methods of lavage. For example, pulsed lavage may cost significantly more than using a jug or syringe due to the equipment and batteries required. However, there was no comparison of the methods of lavage in this evidence review; therefore, no recommendations have been made on this.</p><p>NJR data would have been used had the data been analysed and adjusted for confounding factors. No such data were identified.</p></div></div></div><div id="niceng157er8.rl.r1"><h2 id="_niceng157er8_rl_r1_">References</h2><dl class="temp-labeled-list"><dl class="bkr_refwrap"><dt>1.</dt><dd><div class="bk_ref" id="niceng157er8.ref1">Abdelaziz
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SC. Intrasite antibiotic powder for the prevention of surgical site infection in extremity surgery: A systematic review. Journal of the American Academy of Orthopaedic Surgeons. 2019; 16:16 [<a href="https://pubmed.ncbi.nlm.nih.gov/31008873" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 31008873</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>12.</dt><dd><div class="bk_ref" id="niceng157er8.ref12">Frisch
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JJ. Intraoperative chlorhexidine irrigation to prevent infection in total hip and knee arthroplasty. Arthroplasty Today. 2017; 3(4):294–297 [<a href="/pmc/articles/PMC5712016/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC5712016</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/29204500" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 29204500</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>13.</dt><dd><div class="bk_ref" id="niceng157er8.ref13">Gupta
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PJGM. The effect of wound irrigation on bacterial comtamination of suction instrumentation during joint prosthesis surgery. Nederlands tijdschrift voor orhopaedie. 1998; 5(1):22</div></dd></dl><dl class="bkr_refwrap"><dt>18.</dt><dd><div class="bk_ref" id="niceng157er8.ref18">Lin
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Skeletal Radiology. 2018; 47 (3):443</div></dd></dl><dl class="bkr_refwrap"><dt>19.</dt><dd><div class="bk_ref" id="niceng157er8.ref19">Lortat-Jacob
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A. Antibiotic prophylaxis in orthopedic surgery. Annales Françaises d’Anesthésie et de Réanimation. 1994; 13:(Suppl 1):S51–60 [<a href="https://pubmed.ncbi.nlm.nih.gov/7778813" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 7778813</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>20.</dt><dd><div class="bk_ref" id="niceng157er8.ref20">Memon
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DS. Evaluation of preoperative cultures before second-stage reimplantation of a total knee prosthesis complicated by infection. A comparison-group study. Journal of Bone and Joint Surgery (American Volume). 2000; 82-A(11):1552–7 [<a href="https://pubmed.ncbi.nlm.nih.gov/11097443" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 11097443</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>22.</dt><dd><div class="bk_ref" id="niceng157er8.ref22">Mortada
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EA. Knee lavage versus intra articular hyaluronan in advanced knee osteoarthritis. Annals of the Rheumatic Disease Conference: Annual European Congress of Rheumatology of the European League Against Rheumatism, EULAR. 2012; 71(Suppl 3)</div></dd></dl><dl class="bkr_refwrap"><dt>23.</dt><dd><div class="bk_ref" id="niceng157er8.ref23">Moseley
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G. Arthroscopic treatment of osteoarthritis of the knee: A prospective, randomized, placebo-controlled trial. Results of a pilot study. American Journal of Sports Medicine. 1996; 24(1):28–34 [<a href="https://pubmed.ncbi.nlm.nih.gov/8638750" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 8638750</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>24.</dt><dd><div class="bk_ref" id="niceng157er8.ref24">National Institute for Health and Care Excellence. Developing NICE guidelines: the manual [updated 2018]. London. National Institute for Health and Care Excellence, 2014. Available from: <a href="http://www.nice.org.uk/article/PMG20/chapter/1%20Introduction%20and%20overview" ref="pagearea=cite-ref&targetsite=external&targetcat=link&targettype=uri">http://www<wbr style="display:inline-block"></wbr>​.nice.org.uk<wbr style="display:inline-block"></wbr>​/article/PMG20/chapter<wbr style="display:inline-block"></wbr>​/1%20Introduction%20and%20overview</a> [<a href="https://pubmed.ncbi.nlm.nih.gov/26677490" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 26677490</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>25.</dt><dd><div class="bk_ref" id="niceng157er8.ref25">National Institute for Health and Care Excellence. Surgical site infections: prevention and treatment. NICE guideline 125. London. National Institute for Health and Care Excellence, 2019. Available from: <a href="https://www.nice.org.uk/guidance/ng125" ref="pagearea=cite-ref&targetsite=external&targetcat=link&targettype=uri">https://www<wbr style="display:inline-block"></wbr>​.nice.org.uk/guidance/ng125</a></div></dd></dl><dl class="bkr_refwrap"><dt>26.</dt><dd><div class="bk_ref" id="niceng157er8.ref26">NHS Supply Chain Catalogue. NHS Supply Chain, 2018. Available from: <a href="http://www.supplychain.nhs.uk/" ref="pagearea=cite-ref&targetsite=external&targetcat=link&targettype=uri">http://www<wbr style="display:inline-block"></wbr>​.supplychain.nhs.uk/</a></div></dd></dl><dl class="bkr_refwrap"><dt>27.</dt><dd><div class="bk_ref" id="niceng157er8.ref27">Norman
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G, Atkinson
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TA, Rowlands
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C, Rithalia
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AD, Crosbie
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EJ
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et al. Intracavity lavage and wound irrigation for prevention of surgical site infection. Cochrane Database of Systematic Reviews
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2017, Issue 10. Art. No.: CD012234. DOI: 10.1002/14651858.CD012234.pub2. [<a href="/pmc/articles/PMC5686649/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC5686649</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/29083473" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 29083473</span></a>] [<a href="http://dx.crossref.org/10.1002/14651858.CD012234.pub2" ref="pagearea=cite-ref&targetsite=external&targetcat=link&targettype=uri">CrossRef</a>]</div></dd></dl><dl class="bkr_refwrap"><dt>28.</dt><dd><div class="bk_ref" id="niceng157er8.ref28">Riesgo
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AM, Park
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BK, Herrero
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CP, Yu
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S, Schwarzkopf
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R, Iorio
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R. Vancomycin povidone-iodine protocol improves survivorship of periprosthetic joint infection treated with irrigation and debridement. Journal of Arthroplasty. 2018; 33(3):847–850 [<a href="https://pubmed.ncbi.nlm.nih.gov/29174761" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 29174761</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>29.</dt><dd><div class="bk_ref" id="niceng157er8.ref29">Shah
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NB, Hersh
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BL, Kreger
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AM, Sayeed
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A, Bullock
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AG, Rothenberger
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SD
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et al. Benefits and Adverse Events Associated with Extended Antibiotic Use in Total Knee Arthroplasty Periprosthetic Joint Infection. Clinical Infectious Diseases. 2019; 04:04 [<a href="/pmc/articles/PMC7768747/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC7768747</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/30944931" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 30944931</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>30.</dt><dd><div class="bk_ref" id="niceng157er8.ref30">Sneath
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RJ, Bindi
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FD, Davies
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J, Parnell
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EJ. The effect of pulsed irrigation on the incidence of heterotopic ossification after total hip arthroplasty. Journal of Arthroplasty. 2001; 16(5):547–551 [<a href="https://pubmed.ncbi.nlm.nih.gov/11503112" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 11503112</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>31.</dt><dd><div class="bk_ref" id="niceng157er8.ref31">Sultan
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AA, Samuel
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LT, Umpierrez
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E, Swiergosz
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A, Rabin
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J, Mahmood
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B
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et al. Routine use of commercial antibiotic-loaded bone cement in primary total joint arthroplasty: A critical analysis of the current evidence. Annals of Translational Medicine. 2019; 7(4):73 [<a href="/pmc/articles/PMC6409235/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC6409235</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/30963068" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 30963068</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>32.</dt><dd><div class="bk_ref" id="niceng157er8.ref32">Teeny
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SM, Dorr
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L, Murata
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G, Conaty
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P. Treatment of infected total knee arthroplasty. Irrigation and debridement versus two-stage reimplantation. Journal of Arthroplasty. 1990; 5(1):35–9 [<a href="https://pubmed.ncbi.nlm.nih.gov/2319246" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 2319246</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>33.</dt><dd><div class="bk_ref" id="niceng157er8.ref33">Timperley
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AJ, Whitehouse
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SL. Mitigating surgical risk in patients undergoing hip arthroplasty for fractures of the proximal femur. Journal of Bone and Joint Surgery - Series B. 2009; 91(7):851–854 [<a href="https://pubmed.ncbi.nlm.nih.gov/19567845" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 19567845</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>34.</dt><dd><div class="bk_ref" id="niceng157er8.ref34">Triantafyllopoulos
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GK, Poultsides
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LA, Zhang
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W, Sculco
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PK, Ma
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Y, Sculco
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TP. Periprosthetic knee infections treated with irrigation and debridement: Outcomes and preoperative predictive factors. Journal of Arthroplasty. 2015; 30(4):649–657 [<a href="https://pubmed.ncbi.nlm.nih.gov/25466169" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 25466169</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>35.</dt><dd><div class="bk_ref" id="niceng157er8.ref35">Turhan
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S. Does the use of antibiotic-loaded bone cement have an effect on deep infection in primary total knee arthroplasty practice?
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Surgical Infections. 2019; 20(3):244–246 [<a href="https://pubmed.ncbi.nlm.nih.gov/30707653" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 30707653</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>36.</dt><dd><div class="bk_ref" id="niceng157er8.ref36">Weenders
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SGM, Nijhof
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MW, Schimmel
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JJP, Goosen
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JHM. Debridement, antibiotics and implant retention in early periprosthetic joint infection after primary total hip arthroplasty: 88 percent survival after two years follow-up. Acta Orthopaedica Belgica. 2016; 82(3):530–538 [<a href="https://pubmed.ncbi.nlm.nih.gov/29119894" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 29119894</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>37.</dt><dd><div class="bk_ref" id="niceng157er8.ref37">Wintzell
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G, Haglund-Akerlind
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Y, Nowak
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J, Larsson
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S. Arthroscopic lavage compared with nonoperative treatment for traumatic primary anterior shoulder dislocation: A 2-year follow-up of a prospective randomized study. Journal of Shoulder and Elbow Surgery. 1999; 8(5):399–402 [<a href="https://pubmed.ncbi.nlm.nih.gov/10543589" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 10543589</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>38.</dt><dd><div class="bk_ref" id="niceng157er8.ref38">Wong
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J, Abrishami
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A, De Silva
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Y, Hasan
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SM, Mahomed
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N, Chung
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F. A randomized controlled trial of topical tranexamic acid for postoperative blood loss in total knee arthroplasty. Anesthesia and Analgesia. 2009; 108:S–22</div></dd></dl><dl class="bkr_refwrap"><dt>39.</dt><dd><div class="bk_ref" id="niceng157er8.ref39">Yazdi
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H, Moradi
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A, Herbort
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M. The effect of gentamicin in irrigating solutions on articular infection prophylaxis during arthroscopic ACL reconstruction. Archives of Orthopaedic and Trauma Surgery. 2014; 134(2):257–261 [<a href="https://pubmed.ncbi.nlm.nih.gov/24323062" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 24323062</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>40.</dt><dd><div class="bk_ref" id="niceng157er8.ref40">Zhao
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J, Zhang
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J, Ji
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X, Li
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X, Qian
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Q, Xu
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Q. Does intramedullary canal irrigation reduce fat emboli? A randomized clinical trial with transesophageal echocardiography. Journal of Arthroplasty. 2015; 30(3):451–455 [<a href="https://pubmed.ncbi.nlm.nih.gov/25458091" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 25458091</span></a>]</div></dd></dl></dl></div><div id="appendixesappgroup1"><h2 id="_appendixesappgroup1_">Appendices</h2><div id="niceng157er8.appa"><h3>Appendix A. Review protocols</h3><p id="niceng157er8.appa.et1"><a href="/books/NBK561387/bin/niceng157er8-appa-et1.pdf" class="bk_dwnld_icn bk_dwnld_pdf">Table 4. Review protocol: Wound lavage</a><span class="small"> (PDF, 214K)</span></p><p id="niceng157er8.appa.tab1"><a href="/books/NBK561387/table/niceng157er8.appa.tab1/?report=objectonly" target="object" rid-ob="figobniceng157er8appatab1" class="figpopup">Table 5. Health economic review protocol</a></p></div><div id="niceng157er8.appb"><h3>Appendix B. Literature search strategies</h3><p>The literature searches for this review are detailed below and complied with the methodology outlined in Developing NICE guidelines: the manual.<a class="bibr" href="#niceng157er8.ref24" rid="niceng157er8.ref24"><sup>24</sup></a></p><p><i>For more detailed information, please see the</i>
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<a href="/books/NBK561387/bin/niceng157er8_bm1.pdf">Methodology Review</a>.</p><div id="niceng157er8.appb.s1"><h4>B.1. Clinical search literature search strategy</h4><p>Searches were constructed using a PICO framework where population (P) terms were combined with Intervention (I) and in some cases Comparison (C) terms. Outcomes (O) are rarely used in search strategies for interventions as these concepts may not be well described in title, abstract or indexes and therefore difficult to retrieve. Search filters were applied to the searches where appropriate.</p><p id="niceng157er8.appb.tab1"><a href="/books/NBK561387/table/niceng157er8.appb.tab1/?report=objectonly" target="object" rid-ob="figobniceng157er8appbtab1" class="figpopup">Table 6. Database date parameters and filters used</a></p><p id="niceng157er8.appb.tab2"><a href="/books/NBK561387/table/niceng157er8.appb.tab2/?report=objectonly" target="object" rid-ob="figobniceng157er8appbtab2" class="figpopup">Medline (Ovid) search terms</a></p><p id="niceng157er8.appb.tab3"><a href="/books/NBK561387/table/niceng157er8.appb.tab3/?report=objectonly" target="object" rid-ob="figobniceng157er8appbtab3" class="figpopup">Embase (Ovid) search terms</a></p><p id="niceng157er8.appb.tab4"><a href="/books/NBK561387/table/niceng157er8.appb.tab4/?report=objectonly" target="object" rid-ob="figobniceng157er8appbtab4" class="figpopup">Cochrane Library (Wiley) search terms</a></p></div><div id="niceng157er8.appb.s2"><h4>B.2. Health Economics literature search strategy</h4><p>Health economic evidence was identified by conducting a broad search relating to the joint replacement population in NHS Economic Evaluation Database (NHS EED – this ceased to be updated after March 2015) and the Health Technology Assessment database (HTA) with no date restrictions. NHS EED and HTA databases are hosted by the Centre for Research and Dissemination (CRD). Additional health economics searches were run in Medline and Embase.</p><p id="niceng157er8.appb.tab5"><a href="/books/NBK561387/table/niceng157er8.appb.tab5/?report=objectonly" target="object" rid-ob="figobniceng157er8appbtab5" class="figpopup">Table 7. Database date parameters and filters used</a></p><p id="niceng157er8.appb.tab6"><a href="/books/NBK561387/table/niceng157er8.appb.tab6/?report=objectonly" target="object" rid-ob="figobniceng157er8appbtab6" class="figpopup">Medline (Ovid) search terms</a></p><p id="niceng157er8.appb.tab7"><a href="/books/NBK561387/table/niceng157er8.appb.tab7/?report=objectonly" target="object" rid-ob="figobniceng157er8appbtab7" class="figpopup">Embase (Ovid) search terms</a></p><p id="niceng157er8.appb.tab8"><a href="/books/NBK561387/table/niceng157er8.appb.tab8/?report=objectonly" target="object" rid-ob="figobniceng157er8appbtab8" class="figpopup">NHS EED and HTA (CRD) search terms</a></p></div></div><div id="niceng157er8.appc"><h3>Appendix C. Clinical evidence selection</h3><p id="niceng157er8.appc.fig1"><a href="/books/NBK561387/figure/niceng157er8.appc.fig1/?report=objectonly" target="object" rid-ob="figobniceng157er8appcfig1" class="figpopup">Figure 1. Flow chart of clinical study selection for the review of wound lavage</a></p></div><div id="niceng157er8.appd"><h3>Appendix D. Health economic evidence selection</h3><p id="niceng157er8.appd.fig1"><a href="/books/NBK561387/figure/niceng157er8.appd.fig1/?report=objectonly" target="object" rid-ob="figobniceng157er8appdfig1" class="figpopup">Figure 2. Flow chart of health economic study selection for the guideline</a></p></div><div id="niceng157er8.appe"><h3>Appendix E. Excluded studies</h3><div id="niceng157er8.appe.s1"><h4>E.1. Excluded clinical studies</h4><p id="niceng157er8.appe.tab1"><a href="/books/NBK561387/table/niceng157er8.appe.tab1/?report=objectonly" target="object" rid-ob="figobniceng157er8appetab1" class="figpopup">Table 8. Studies excluded from the clinical review</a></p></div></div></div></div><div class="fm-sec"><div><p>Final</p></div><div><p>Intervention evidence review underpinning recommendation 1.5.1 in the NICE guideline</p><p>This evidence review was developed by the National Guideline Centre, hosted by the Royal College of Physicians</p></div><div><p><b>Disclaimer:</b> The recommendations in this guideline represent the view of NICE, arrived at after careful consideration of the evidence available. When exercising their judgement, professionals are expected to take this guideline fully into account, alongside the individual needs, preferences and values of their patients or service users. The recommendations in this guideline are not mandatory and the guideline does not override the responsibility of healthcare professionals to make decisions appropriate to the circumstances of the individual patient, in consultation with the patient and, where appropriate, their carer or guardian.</p><p>Local commissioners and providers have a responsibility to enable the guideline to be applied when individual health professionals and their patients or service users wish to use it. They should do so in the context of local and national priorities for funding and developing services, and in light of their duties to have due regard to the need to eliminate unlawful discrimination, to advance equality of opportunity and to reduce health inequalities. Nothing in this guideline should be interpreted in a way that would be inconsistent with compliance with those duties.</p><p>NICE guidelines cover health and care in England. Decisions on how they apply in other UK countries are made by ministers in the <a href="http://wales.gov.uk/" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Welsh Government</a>, <a href="http://www.scotland.gov.uk/" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Scottish Government</a>, and <a href="http://www.northernireland.gov.uk/" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Northern Ireland Executive</a>. All NICE guidance is subject to regular review and may be updated or withdrawn.</p></div><div class="half_rhythm"><a href="/books/about/copyright/">Copyright</a> © NICE 2020.</div><div class="small"><span class="label">Bookshelf ID: NBK561387</span><span class="label">PMID: <a href="https://pubmed.ncbi.nlm.nih.gov/32881454" title="PubMed record of this title" ref="pagearea=meta&targetsite=entrez&targetcat=link&targettype=pubmed">32881454</a></span></div></div><div class="small-screen-prev"></div><div class="small-screen-next"></div></article><article data-type="table-wrap" id="figobniceng157er8tab1"><div id="niceng157er8.tab1" class="table"><h3><span class="label">Table 1</span><span class="title">PICO characteristics of review question</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK561387/table/niceng157er8.tab1/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__niceng157er8.tab1_lrgtbl__"><table><tbody><tr><th id="hd_b_niceng157er8.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Population</th><td headers="hd_b_niceng157er8.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Adults having primary elective joint replacement.</td></tr><tr><th id="hd_b_niceng157er8.tab1_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Interventions</th><td headers="hd_b_niceng157er8.tab1_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<ul><li class="half_rhythm"><div>Wound lavage with saline and antiseptic agent(s)</div></li><li class="half_rhythm"><div>Wound lavage with saline and antibiotic agent(s)</div></li><li class="half_rhythm"><div>Wound lavage with saline and antiseptic and antibiotic agents</div></li></ul></td></tr><tr><th id="hd_b_niceng157er8.tab1_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Comparisons</th><td headers="hd_b_niceng157er8.tab1_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<ul><li class="half_rhythm"><div>Wound lavage with saline</div></li></ul></td></tr><tr><th id="hd_b_niceng157er8.tab1_1_1_4_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Outcomes</th><td headers="hd_b_niceng157er8.tab1_1_1_4_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"><u>Critical</u>
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<ul><li class="half_rhythm"><div>Mortality at 30 days</div></li><li class="half_rhythm"><div>Quality of life</div></li><li class="half_rhythm"><div>Superficial Surgical site infection</div></li><li class="half_rhythm"><div>Deep surgical site infection</div></li></ul>
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<u>Important</u>
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<ul><li class="half_rhythm"><div>Return to theatre</div></li><li class="half_rhythm"><div>Allergic reaction</div></li><li class="half_rhythm"><div>Adverse antibiotic reactions</div></li><li class="half_rhythm"><div>Hospital readmission</div></li><li class="half_rhythm"><div>Pain</div></li><li class="half_rhythm"><div>Length of stay</div></li></ul></td></tr><tr><th id="hd_b_niceng157er8.tab1_1_1_5_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Study design</th><td headers="hd_b_niceng157er8.tab1_1_1_5_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>Randomised controlled trials</p>
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<p>If no well-conducted RCTs are available, then observational studies with multivariate analysis will be investigated.</p>
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</td></tr></tbody></table></div></div></article><article data-type="table-wrap" id="figobniceng157er8tab2"><div id="niceng157er8.tab2" class="table"><h3><span class="label">Table 2</span><span class="title">UK costs for irrigation solution composition</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK561387/table/niceng157er8.tab2/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__niceng157er8.tab2_lrgtbl__"><table class="no_bottom_margin"><thead><tr><th id="hd_h_niceng157er8.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Active Ingredient</th><th id="hd_h_niceng157er8.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Size</th><th id="hd_h_niceng157er8.tab2_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Unit Cost</th><th id="hd_h_niceng157er8.tab2_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Cost (per litre)</th></tr></thead><tbody><tr><td headers="hd_h_niceng157er8.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Sodium chloride 9 mg per 1 ml<sup>(a)</sup></td><td headers="hd_h_niceng157er8.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">1000ml</td><td headers="hd_h_niceng157er8.tab2_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">£1.09</td><td headers="hd_h_niceng157er8.tab2_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">£1.09</td></tr><tr><td headers="hd_h_niceng157er8.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Chlorhexidine gluconate 5 mg per 1 ml</td><td headers="hd_h_niceng157er8.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">600ml</td><td headers="hd_h_niceng157er8.tab2_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">£4.72</td><td headers="hd_h_niceng157er8.tab2_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">£7.87</td></tr><tr><td headers="hd_h_niceng157er8.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Chlorhexidine gluconate 40 mg per 1 ml</td><td headers="hd_h_niceng157er8.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">500ml</td><td headers="hd_h_niceng157er8.tab2_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">£5.25</td><td headers="hd_h_niceng157er8.tab2_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">£10.50</td></tr><tr><td headers="hd_h_niceng157er8.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Povidone-Iodine 75 mg per 1 ml</td><td headers="hd_h_niceng157er8.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">500ml</td><td headers="hd_h_niceng157er8.tab2_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">£7.67</td><td headers="hd_h_niceng157er8.tab2_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">£15.34</td></tr><tr><td headers="hd_h_niceng157er8.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Vancomycin (as Vancomycin hydrochloride)</td><td headers="hd_h_niceng157er8.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">500mg</td><td headers="hd_h_niceng157er8.tab2_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">£6.25</td><td headers="hd_h_niceng157er8.tab2_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">£13.59<sup>(b)</sup></td></tr></tbody></table></div><div class="tblwrap-foot"><div><dl class="temp-labeled-list small"><dl class="bkr_refwrap"><dt></dt><dd><div><p class="no_margin">Source: Joint Formulary Committee<a class="bibr" href="#niceng157er8.ref15" rid="niceng157er8.ref15"><sup>15</sup></a></p></div></dd></dl><dl class="bkr_refwrap"><dt>(a)</dt><dd><div id="niceng157er8.tab2_1"><p class="no_margin">Costs only available for 1L bags when 3L more commonly used</p></div></dd></dl><dl class="bkr_refwrap"><dt>(b)</dt><dd><div id="niceng157er8.tab2_2"><p class="no_margin">When used as a concentration of 1g/L, cost includes 1L saline solution as listed above</p></div></dd></dl></dl></div></div></div></article><article data-type="table-wrap" id="figobniceng157er8tab3"><div id="niceng157er8.tab3" class="table"><h3><span class="label">Table 3</span><span class="title">UK costs for irrigation delivery method</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK561387/table/niceng157er8.tab3/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__niceng157er8.tab3_lrgtbl__"><table class="no_bottom_margin"><thead><tr><th id="hd_h_niceng157er8.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Site of surgery</th><th id="hd_h_niceng157er8.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Brand</th><th id="hd_h_niceng157er8.tab3_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Model description</th><th id="hd_h_niceng157er8.tab3_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Unit Cost</th></tr></thead><tbody><tr><td headers="hd_h_niceng157er8.tab3_1_1_1_1" rowspan="6" colspan="1" style="text-align:center;vertical-align:middle;">Hip or Knee</td><td headers="hd_h_niceng157er8.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Fannin</td><td headers="hd_h_niceng157er8.tab3_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Clean disposable pulse lavage system</td><td headers="hd_h_niceng157er8.tab3_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">£21.03</td></tr><tr><td headers="hd_h_niceng157er8.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Tava</td><td headers="hd_h_niceng157er8.tab3_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Single use pulse lavage system</td><td headers="hd_h_niceng157er8.tab3_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">£21.65</td></tr><tr><td headers="hd_h_niceng157er8.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Morgan Steer</td><td headers="hd_h_niceng157er8.tab3_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Microaire fan kit including fully-disposable pulse lavage component kit and fan spray tip with splash shield</td><td headers="hd_h_niceng157er8.tab3_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">£34.77</td></tr><tr><td headers="hd_h_niceng157er8.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Ortho Dynamics</td><td headers="hd_h_niceng157er8.tab3_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Knee or hip kit including fully disposable pulse lavage component kit and shower spray tip with splash shield</td><td headers="hd_h_niceng157er8.tab3_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">£38.40</td></tr><tr><td headers="hd_h_niceng157er8.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">MDM Medical ltd</td><td headers="hd_h_niceng157er8.tab3_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Single use pulse lavage system with knee tip only</td><td headers="hd_h_niceng157er8.tab3_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">£48.87</td></tr><tr><td headers="hd_h_niceng157er8.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">No brand listed</td><td headers="hd_h_niceng157er8.tab3_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Eco hip arthroplasty brush pump lavage kit with suction 702</td><td headers="hd_h_niceng157er8.tab3_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">£50.54</td></tr><tr><td headers="hd_h_niceng157er8.tab3_1_1_1_1" rowspan="2" colspan="1" style="text-align:center;vertical-align:middle;">Shoulder</td><td headers="hd_h_niceng157er8.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Rocialle</td><td headers="hd_h_niceng157er8.tab3_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Sterile 1 litre jug</td><td headers="hd_h_niceng157er8.tab3_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">£0.49</td></tr><tr><td headers="hd_h_niceng157er8.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">BD Plastipak</td><td headers="hd_h_niceng157er8.tab3_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">50ml catheter syringe</td><td headers="hd_h_niceng157er8.tab3_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">£0.35</td></tr></tbody></table></div><div class="tblwrap-foot"><div><dl class="temp-labeled-list small"><dl class="bkr_refwrap"><dt></dt><dd><div><p class="no_margin">Source: NHS Supply Catalogue 2018<a class="bibr" href="#niceng157er8.ref26" rid="niceng157er8.ref26"><sup>26</sup></a></p></div></dd></dl></dl></div></div></div></article><article data-type="table-wrap" id="figobniceng157er8appatab1"><div id="niceng157er8.appa.tab1" class="table"><h3><span class="label">Table 5</span><span class="title">Health economic review protocol</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK561387/table/niceng157er8.appa.tab1/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__niceng157er8.appa.tab1_lrgtbl__"><table><thead><tr><th id="hd_h_niceng157er8.appa.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Review question</th><th id="hd_h_niceng157er8.appa.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">All questions – health economic evidence</th></tr></thead><tbody><tr><td headers="hd_h_niceng157er8.appa.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<b>Objectives</b>
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</td><td headers="hd_h_niceng157er8.appa.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">To identify health economic studies relevant to any of the review questions.</td></tr><tr><td headers="hd_h_niceng157er8.appa.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<b>Search criteria</b>
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</td><td headers="hd_h_niceng157er8.appa.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<ul><li class="half_rhythm"><div>Populations, interventions and comparators must be as specified in the clinical review protocol above.</div></li><li class="half_rhythm"><div>Studies must be of a relevant health economic study design (cost–utility analysis, cost-effectiveness analysis, cost–benefit analysis, cost–consequences analysis, comparative cost analysis).</div></li><li class="half_rhythm"><div>Studies must not be a letter, editorial or commentary, or a review of health economic evaluations. (Recent reviews will be ordered although not reviewed. The bibliographies will be checked for relevant studies, which will then be ordered.)</div></li><li class="half_rhythm"><div>Unpublished reports will not be considered unless submitted as part of a call for evidence.</div></li><li class="half_rhythm"><div>Studies must be in English.</div></li></ul></td></tr><tr><td headers="hd_h_niceng157er8.appa.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<b>Search strategy</b>
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</td><td headers="hd_h_niceng157er8.appa.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">A health economic study search will be undertaken using population-specific terms and a health economic study filter – see <a href="#niceng157er8.appb">appendix B</a> below.</td></tr><tr><td headers="hd_h_niceng157er8.appa.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<b>Review strategy</b>
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</td><td headers="hd_h_niceng157er8.appa.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>Studies not meeting any of the search criteria above will be excluded. Studies published before 2003, abstract-only studies and studies from low or middle-income countries (e.g. most non-OECD countries) or the USA will also be excluded.</p>
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<p>Each remaining study will be assessed for applicability and methodological limitations using the NICE economic evaluation checklist which can be found in appendix H of Developing NICE guidelines: the manual (2014).<a class="bibr" href="#niceng157er8.ref24" rid="niceng157er8.ref24"><sup>24</sup></a></p>
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<p><b>Inclusion and exclusion criteria</b>
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<ul><li class="half_rhythm"><div>If a study is rated as both ‘Directly applicable’ and with ‘Minor limitations’ then it will be included in the guideline. A health economic evidence table will be completed and it will be included in the health economic evidence profile.</div></li><li class="half_rhythm"><div>If a study is rated as either ‘Not applicable’ or with ‘Very serious limitations’ then it will usually be excluded from the guideline. If it is excluded then a health economic evidence table will not be completed and it will not be included in the health economic evidence profile.</div></li><li class="half_rhythm"><div>If a study is rated as ‘Partially applicable’, with ‘Potentially serious limitations’ or both then there is discretion over whether it should be included.</div></li></ul>
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<b>Where there is discretion</b></p>
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<p>The health economist will make a decision based on the relative applicability and quality of the available evidence for that question, in discussion with the guideline committee if required. The ultimate aim is to include health economic studies that are helpful for decision-making in the context of the guideline and the current NHS setting. If several studies are considered of sufficiently high applicability and methodological quality that they could all be included, then the health economist, in discussion with the committee if required, may decide to include only the most applicable studies and to selectively exclude the remaining studies. All studies excluded on the basis of applicability or methodological limitations will be listed with explanation in the excluded health economic studies appendix below.</p>
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<p>The health economist will be guided by the following hierarchies.</p>
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<p><i>Setting:</i>
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<ul><li class="half_rhythm"><div>UK NHS (most applicable).</div></li><li class="half_rhythm"><div>OECD countries with predominantly public health insurance systems (for example, France, Germany, Sweden).</div></li><li class="half_rhythm"><div>OECD countries with predominantly private health insurance systems (for example, Switzerland).</div></li><li class="half_rhythm"><div>Studies set in non-OECD countries or in the USA will be excluded before being assessed for applicability and methodological limitations.</div></li></ul>
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<i>Health economic study type:</i>
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<ul><li class="half_rhythm"><div>Cost–utility analysis (most applicable).</div></li><li class="half_rhythm"><div>Other type of full economic evaluation (cost–benefit analysis, cost-effectiveness analysis, cost–consequences analysis).</div></li><li class="half_rhythm"><div>Comparative cost analysis.</div></li><li class="half_rhythm"><div>Non-comparative cost analyses including cost-of-illness studies will be excluded before being assessed for applicability and methodological limitations.</div></li></ul>
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<i>Year of analysis:</i>
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<ul><li class="half_rhythm"><div>The more recent the study, the more applicable it will be.</div></li><li class="half_rhythm"><div>Studies published in 2003 or later but that depend on unit costs and resource data entirely or predominantly from before 2003 will be rated as ‘Not applicable’.</div></li><li class="half_rhythm"><div>Studies published before 2003 will be excluded before being assessed for applicability and methodological limitations.</div></li></ul>
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<i>Quality and relevance of effectiveness data used in the health economic analysis:</i>
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<ul><li class="half_rhythm"><div>The more closely the clinical effectiveness data used in the health economic analysis match with the outcomes of the studies included in the clinical review the more useful the analysis will be for decision-making in the guideline.</div></li></ul>
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</p>
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</td></tr></tbody></table></div></div></article><article data-type="table-wrap" id="figobniceng157er8appbtab1"><div id="niceng157er8.appb.tab1" class="table"><h3><span class="label">Table 6</span><span class="title">Database date parameters and filters used</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK561387/table/niceng157er8.appb.tab1/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__niceng157er8.appb.tab1_lrgtbl__"><table><thead><tr><th id="hd_h_niceng157er8.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Database</th><th id="hd_h_niceng157er8.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Dates searched</th><th id="hd_h_niceng157er8.appb.tab1_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Search filter used</th></tr></thead><tbody><tr><td headers="hd_h_niceng157er8.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Medline (OVID)</td><td headers="hd_h_niceng157er8.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">1946 – 01 May 2019</td><td headers="hd_h_niceng157er8.appb.tab1_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>Exclusions</p>
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<p>Randomised controlled trials</p>
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<p>Systematic review studies</p>
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<p>Observational studies</p>
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</td></tr><tr><td headers="hd_h_niceng157er8.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Embase (OVID)</td><td headers="hd_h_niceng157er8.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">1974 – 01 May 2019</td><td headers="hd_h_niceng157er8.appb.tab1_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>Exclusions</p>
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<p>Randomised controlled trials</p>
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<p>Systematic review studies</p>
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<p>Observational studies</p>
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</td></tr><tr><td headers="hd_h_niceng157er8.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">The Cochrane Library (Wiley)</td><td headers="hd_h_niceng157er8.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>Cochrane Reviews to 2019 Issue 5 of 12</p>
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<p>CENTRAL to 2019 Issue 5 of 12</p>
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<p>DARE, and NHSEED to 2015 Issue 2 of 4</p>
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<p>HTA to 2016 Issue 4 of 4</p>
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</td><td headers="hd_h_niceng157er8.appb.tab1_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">None</td></tr></tbody></table></div></div></article><article data-type="table-wrap" id="figobniceng157er8appbtab2"><div id="niceng157er8.appb.tab2" class="table"><h3><span class="title">Medline (Ovid) search terms</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK561387/table/niceng157er8.appb.tab2/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__niceng157er8.appb.tab2_lrgtbl__"><table><tbody><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">1.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">arthroplasty/ or arthroplasty, replacement/ or arthroplasty, replacement, hip/ or arthroplasty, replacement, knee/ or arthroplasty, replacement, shoulder/ or hemiarthroplasty/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">2.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">joint prosthesis/ or hip prosthesis/ or knee prosthesis/ or shoulder prosthesis/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">3.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">((joint* or knee* or shoulder* or hip*) adj5 (surger* or replace* or prosthe* or endoprosthe* or implant* or artificial or arthroplast* or hemiarthroplast*)).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">4.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">or/1-3</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">5.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">letter/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">6.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">editorial/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">7.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">news/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">8.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp historical article/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">9.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Anecdotes as Topic/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">10.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">comment/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">11.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">case report/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">12.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(letter or comment*).ti.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">13.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">or/5-12</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">14.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">randomized controlled trial/ or random*.ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">15.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">13 not 14</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">16.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">animals/ not humans/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">17.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp Animals, Laboratory/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">18.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp Animal Experimentation/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">19.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp Models, Animal/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">20.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp Rodentia/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">21.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(rat or rats or mouse or mice).ti.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">22.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">or/15-21</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">23.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">4 not 22</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">24.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">limit 23 to English language</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">25.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Therapeutic Irrigation/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">26.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(irrigat* or lavage or douch*).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">27.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(wound* adj5 (clean* or decontaminat* or soak* or rins* or wash*)).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">28.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(water or H2O or saline or solution* or soap* or detergent*).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">29.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">((Intraoperative or intra-operative or operative or surg*) adj3 (clean* or decontaminat* or soak* or rins* or wash*)).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">30.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">((medicat* or pump* or power-puls* or puls* or power assist* or assist* or pressure* or manual) adj3 (wash* or clean*)).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">31.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Saline Solution, Hypertonic/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">32.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Detergents/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">33.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Soaps/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">34.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Water/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">35.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Solutions/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">36.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">or/25-35</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">37.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Anti-bacterial agents/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">38.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Cephalosporins/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">39.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Vancomycin/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">40.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Gentamicins/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">41.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Bacitracin/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">42.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(antibiotic* or anti-biotic* or antibacteri* or anti-bacteri* or cephalosporin* or vancomycin or gentamicin* or bacitracin).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">43.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">or/37-42</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">44.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Anti-Infective Agents, Local/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">45.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Chlorhexidine/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">46.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Hydrogen Peroxide/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">47.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Povidone-Iodine/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">48.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Iodine/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">49.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Hypochlorous Acid/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">50.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(antiseptic* or antimicrobi* or anti-microbi* or anti-infecti* or antiinfective or chlorhexidine* or peroxide* or povidone* or iodine or betadine or hypochlor*).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">51.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">or/44-50</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">52.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">24 and (36 or 43 or 51)</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">53.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">randomized controlled trial.pt.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">54.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">controlled clinical trial.pt.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">55.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">randomi#ed.ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">56.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">placebo.ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">57.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">randomly.ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">58.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Clinical Trials as topic.sh.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">59.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">trial.ti.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">60.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">or/53-59</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">61.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Meta-Analysis/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">62.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp Meta-Analysis as Topic/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">63.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(meta analy* or metanaly* or metaanaly* or meta regression).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">64.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">((systematic* or evidence*) adj3 (review* or overview*)).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">65.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(reference list* or bibliograph* or hand search* or manual search* or relevant journals).ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">66.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(search strategy or search criteria or systematic search or study selection or data extraction).ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">67.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(search* adj4 literature).ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">68.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(medline or pubmed or cochrane or embase or psychlit or psyclit or psychinfo or psycinfo or cinahl or science citation index or bids or cancerlit).ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">69.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">cochrane.jw.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">70.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">((multiple treatment* or indirect or mixed) adj2 comparison*).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">71.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">or/61-70</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">72.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Epidemiologic studies/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">73.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Observational study/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">74.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp Cohort studies/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">75.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(cohort adj (study or studies or analys* or data)).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">76.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">((follow up or observational or uncontrolled or non randomi#ed or epidemiologic*) adj (study or studies or data)).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">77.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">((longitudinal or retrospective or prospective or cross sectional) and (study or studies or review or analys* or cohort* or data)).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">78.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Controlled Before-After Studies/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">79.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Historically Controlled Study/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">80.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Interrupted Time Series Analysis/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">81.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(before adj2 after adj2 (study or studies or data)).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">82.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">or/73-82</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">83.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp case control study/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">84.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">case control*.ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">85.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">or/84-85</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">86.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">83 or 86</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">87.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Cross-sectional studies/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">88.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(cross sectional and (study or studies or review or analys* or cohort* or data)).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">89.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">or/88-89</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">90.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">83 or 90</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">91.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">83 or 86 or 90</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">92.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">52 and (60 or 71 or 91)</td></tr></tbody></table></div></div></article><article data-type="table-wrap" id="figobniceng157er8appbtab3"><div id="niceng157er8.appb.tab3" class="table"><h3><span class="title">Embase (Ovid) search terms</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK561387/table/niceng157er8.appb.tab3/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__niceng157er8.appb.tab3_lrgtbl__"><table><tbody><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">1.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">*arthroplasty/ or *replacement arthroplasty/ or *hip replacement/ or *knee replacement/ or *shoulder replacement/ or *hemiarthroplasty/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">2.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">*joint prosthesis/ or *hip prosthesis/ or *knee prosthesis/ or *shoulder prosthesis/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">3.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">((joint* or knee* or shoulder* or hip*) adj5 (surger* or replace* or prosthe* or endoprosthe* or implant* or artificial or arthroplast* or hemiarthroplast*)).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">4.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">or/1-3</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">5.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">letter.pt. or letter/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">6.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">note.pt.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">7.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">editorial.pt.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">8.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">case report/ or case study/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">9.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(letter or comment*).ti.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">10.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">or/5-9</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">11.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">randomized controlled trial/ or random*.ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">12.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">10 not 11</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">13.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">animal/ not human/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">14.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">nonhuman/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">15.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp Animal Experiment/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">16.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp Experimental Animal/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">17.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">animal model/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">18.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp Rodent/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">19.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(rat or rats or mouse or mice).ti.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">20.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">or/12-19</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">21.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">4 not 20</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">22.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">limit 21 to English language</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">23.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">lavage/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">24.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(irrigat* or lavage or douch*).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">25.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(wound* adj5 (clean* or decontaminat* or soak* or rins* or wash*)).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">26.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(water or H2O or saline or solution* or soap* or detergent*).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">27.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">((Intraoperative or intra-operative or operative or surg*) adj3 (clean* or decontaminat* or soak* or rins* or wash*)).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">28.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">((medicat* or pump* or power-puls* or puls* or power assist* or assist* or pressure* or manual) adj3 (wash* or clean*)).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">29.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">hypertonic solution/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">30.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">detergent/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">31.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">soap/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">32.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">water/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">33.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">"solution and solubility"/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">34.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">or/23-33</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">35.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">antibiotic agent/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">36.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">cephalosporin derivative/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">37.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">vancomycin/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">38.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">gentamicin/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">39.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">bacitracin/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">40.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(antibiotic* or anti-biotic* or antibacteri* or anti-bacteri* or cephalosporin* or vancomycin or gentamicin* or bacitracin).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">41.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">or/35-40</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">42.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">antiinfective agent/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">43.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">chlorhexidine/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">44.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">hydrogen peroxide/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">45.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">povidone iodine/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">46.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">iodine/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">47.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">hypochlorous acid/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">48.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(antiseptic* or antimicrobi* or anti-microbi* or anti-infecti* or antiinfective or chlorhexidine* or peroxide* or povidone* or iodine or betadine or hypochlor*).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">49.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">or/42-48</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">50.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">22 and (34 or 41 or 49)</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">51.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">random*.ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">52.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">factorial*.ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">53.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(crossover* or cross over*).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">54.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">((doubl* or singl*) adj blind*).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">55.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(assign* or allocat* or volunteer* or placebo*).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">56.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">crossover procedure/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">57.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">single blind procedure/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">58.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">randomized controlled trial/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">59.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">double blind procedure/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">60.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">or/51-59</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">61.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">systematic review/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">62.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">meta-analysis/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">63.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(meta analy* or metanaly* or metaanaly* or meta regression).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">64.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">((systematic* or evidence*) adj3 (review* or overview*)).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">65.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(reference list* or bibliograph* or hand search* or manual search* or relevant journals).ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">66.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(search strategy or search criteria or systematic search or study selection or data extraction).ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">67.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(search* adj4 literature).ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">68.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(medline or pubmed or cochrane or embase or psychlit or psyclit or psychinfo or psycinfo or cinahl or science citation index or bids or cancerlit).ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">69.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">cochrane.jw.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">70.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">((multiple treatment* or indirect or mixed) adj2 comparison*).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">71.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">or/61-70</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">72.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Clinical study/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">73.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Observational study/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">74.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">family study/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">75.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">longitudinal study/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">76.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">retrospective study/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">77.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">prospective study/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">78.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">cohort analysis/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">79.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">follow-up/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">80.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">cohort*.ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">81.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">80 and 81</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">82.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(cohort adj (study or studies or analys* or data)).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">83.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">((follow up or observational or uncontrolled or non randomi#ed or epidemiologic*) adj (study or studies or data)).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">84.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">((longitudinal or retrospective or prospective or cross sectional) and (study or studies or review or analys* or cohort* or data)).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">85.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(before adj2 after adj2 (study or studies or data)).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">86.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">or/73-79,82-86</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">87.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp case control study/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">88.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">case control*.ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">89.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">or/88-89</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">90.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">or 90</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">91.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">cross-sectional study/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">92.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(cross sectional and (study or studies or review or analys* or cohort* or data)).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">93.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">or/92-93</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">94.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">or 94</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">95.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">or 90 or 94</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">96.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">and (60 or 71 or 95)</td></tr></tbody></table></div></div></article><article data-type="table-wrap" id="figobniceng157er8appbtab4"><div id="niceng157er8.appb.tab4" class="table"><h3><span class="title">Cochrane Library (Wiley) search terms</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK561387/table/niceng157er8.appb.tab4/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__niceng157er8.appb.tab4_lrgtbl__"><table><tbody><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#1.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MeSH descriptor: [Arthroplasty] this term only</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#2.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MeSH descriptor: [Arthroplasty, Replacement] this term only</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#3.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MeSH descriptor: [Arthroplasty, Replacement, Hip] this term only</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#4.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MeSH descriptor: [Arthroplasty, Replacement, Knee] this term only</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#5.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MeSH descriptor: [Arthroplasty, Replacement, Shoulder] this term only</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#6.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MeSH descriptor: [Hemiarthroplasty] this term only</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#7.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(or #1-#6)</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#8.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MeSH descriptor: [Joint Prosthesis] this term only</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#9.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MeSH descriptor: [Hip Prosthesis] this term only</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#10.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MeSH descriptor: [Knee Prosthesis] this term only</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#11.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MeSH descriptor: [Shoulder Prosthesis] this term only</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#12.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(or #8-#11)</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#13.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">((joint* or knee* or shoulder* or hip*) near/5 (surger* or replace* or prosthe* or endoprosthe* or implant* or artificial or arthroplast* or hemiarthroplast*)):ti,ab</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#14.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(or #7, #12-#13)</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#15.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MeSH descriptor: [Therapeutic Irrigation] this term only</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#16.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(irrigat* or lavage or douch*):ti,ab</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#17.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(wound* near/5 (clean* or decontaminat* or soak* or rins* or wash*)):ti,ab</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#18.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(water or H2O or saline or solution* or soap* or detergent*):ti,ab</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#19.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">((Intraoperative or intra-operative or operative or surg*) near/3 (clean* or decontaminat* or soak* or rins* or wash*)):ti,ab</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#20.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">((medicat* or pump* or power-puls* or puls* or power assist* or assist* or pressure* or manual) near/3 (wash* or clean*)):ti,ab</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#21.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MeSH descriptor: [Saline Solution, Hypertonic] this term only</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#22.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MeSH descriptor: [Detergents] this term only</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#23.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MeSH descriptor: [Soaps] this term only</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#24.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MeSH descriptor: [Water] this term only</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#25.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MeSH descriptor: [Solutions] this term only</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#26.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(or #15-#25)</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#27.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MeSH descriptor: [Anti-Bacterial Agents] this term only</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#28.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MeSH descriptor: [Cephalosporins] this term only</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#29.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MeSH descriptor: [Vancomycin] this term only</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#30.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MeSH descriptor: [Gentamicins] this term only</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#31.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MeSH descriptor: [Bacitracin] this term only</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#32.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(antibiotic* or anti-biotic* or antibacteri* or anti-bacteri* or cephalosporin* or vancomycin or gentamicin* or bacitracin):ti,ab</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#33.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(or #27-#32)</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#34.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MeSH descriptor: [Anti-Infective Agents, Local] this term only</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#35.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MeSH descriptor: [Chlorhexidine] this term only</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#36.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MeSH descriptor: [Hydrogen Peroxide] this term only</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#37.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MeSH descriptor: [Povidone-Iodine] this term only</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#38.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MeSH descriptor: [Iodine] this term only</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#39.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MeSH descriptor: [Hypochlorous Acid] this term only</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#40.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(antiseptic* or antimicrobi* or anti-microbi* or anti-infecti* or antiinfective or chlorhexidine* or peroxide* or povidone* or iodine or betadine or hypochlor*):ti,ab</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#41.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(or #34-#40)</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#42.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#14 and (or #26, #33, #41)</td></tr></tbody></table></div></div></article><article data-type="table-wrap" id="figobniceng157er8appbtab5"><div id="niceng157er8.appb.tab5" class="table"><h3><span class="label">Table 7</span><span class="title">Database date parameters and filters used</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK561387/table/niceng157er8.appb.tab5/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__niceng157er8.appb.tab5_lrgtbl__"><table><thead><tr><th id="hd_h_niceng157er8.appb.tab5_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Database</th><th id="hd_h_niceng157er8.appb.tab5_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Dates searched</th><th id="hd_h_niceng157er8.appb.tab5_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Search filter used</th></tr></thead><tbody><tr><td headers="hd_h_niceng157er8.appb.tab5_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Medline</td><td headers="hd_h_niceng157er8.appb.tab5_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">2014 – 01 May 2019</td><td headers="hd_h_niceng157er8.appb.tab5_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Exclusions</p>
|
|
<p>Health economics studies</p>
|
|
</td></tr><tr><td headers="hd_h_niceng157er8.appb.tab5_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Embase</td><td headers="hd_h_niceng157er8.appb.tab5_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">2014 – 01 May 2019</td><td headers="hd_h_niceng157er8.appb.tab5_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Exclusions</p>
|
|
<p>Health economics studies</p>
|
|
</td></tr><tr><td headers="hd_h_niceng157er8.appb.tab5_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Centre for Research and Dissemination (CRD)</td><td headers="hd_h_niceng157er8.appb.tab5_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>HTA - Inception – 01 May 2019</p>
|
|
<p>NHSEED - Inception to March 2015</p>
|
|
</td><td headers="hd_h_niceng157er8.appb.tab5_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">None</td></tr></tbody></table></div></div></article><article data-type="table-wrap" id="figobniceng157er8appbtab6"><div id="niceng157er8.appb.tab6" class="table"><h3><span class="title">Medline (Ovid) search terms</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK561387/table/niceng157er8.appb.tab6/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__niceng157er8.appb.tab6_lrgtbl__"><table><tbody><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">1.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">arthroplasty/ or arthroplasty, replacement/ or arthroplasty, replacement, hip/ or arthroplasty, replacement, knee/ or arthroplasty, replacement, shoulder/ or hemiarthroplasty/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">2.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">joint prosthesis/ or hip prosthesis/ or knee prosthesis/ or shoulder prosthesis/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">3.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">((joint* or knee* or shoulder* or hip*) adj5 (surger* or replace* or prosthe* or endoprosthe* or implant* or artificial or arthroplast* or hemiarthroplast*)).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">4.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">or/1-3</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">5.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">letter/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">6.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">editorial/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">7.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">news/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">8.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp historical article/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">9.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Anecdotes as Topic/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">10.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">comment/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">11.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">case report/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">12.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(letter or comment*).ti.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">13.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">or/5-12</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">14.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">randomized controlled trial/ or random*.ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">15.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">13 not 14</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">16.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">animals/ not humans/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">17.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp Animals, Laboratory/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">18.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp Animal Experimentation/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">19.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp Models, Animal/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">20.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp Rodentia/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">21.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(rat or rats or mouse or mice).ti.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">22.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">or/15-21</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">23.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">4 not 22</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">24.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">limit 23 to English language</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">25.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Economics/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">26.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Value of life/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">27.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp “Costs and Cost Analysis”/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">28.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp Economics, Hospital/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">29.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp Economics, Medical/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">30.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Economics, Nursing/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">31.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Economics, Pharmaceutical/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">32.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp “Fees and Charges”/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">33.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp Budgets/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">34.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">budget*.ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">35.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">cost*.ti.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">36.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(economic* or pharmaco?economic*).ti.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">37.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(price* or pricing*).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">38.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(cost* adj2 (effective* or utilit* or benefit* or minimi* or unit* or estimat* or variable*)).ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">39.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(financ* or fee or fees).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">40.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(value adj2 (money or monetary)).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">41.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">or/25-40</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">42.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">24 and 41</td></tr></tbody></table></div></div></article><article data-type="table-wrap" id="figobniceng157er8appbtab7"><div id="niceng157er8.appb.tab7" class="table"><h3><span class="title">Embase (Ovid) search terms</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK561387/table/niceng157er8.appb.tab7/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__niceng157er8.appb.tab7_lrgtbl__"><table><tbody><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">1.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">*arthroplasty/ or *replacement arthroplasty/ or *hip replacement/ or *knee replacement/ or *shoulder replacement/ or *hemiarthroplasty/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">2.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">*joint prosthesis/ or *hip prosthesis/ or *knee prosthesis/ or *shoulder prosthesis/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">3.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">((joint* or knee* or shoulder* or hip*) adj5 (surger* or replace* or prosthe* or endoprosthe* or implant* or artificial or arthroplast* or hemiarthroplast*)).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">4.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">or/1-3</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">5.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">letter.pt. or letter/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">6.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">note.pt.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">7.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">editorial.pt.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">8.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">case report/ or case study/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">9.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(letter or comment*).ti.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">10.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">or/5-9</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">11.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">randomized controlled trial/ or random*.ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">12.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">10 not 11</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">13.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">animal/ not human/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">14.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">nonhuman/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">15.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp Animal Experiment/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">16.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp Experimental Animal/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">17.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">animal model/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">18.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp Rodent/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">19.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(rat or rats or mouse or mice).ti.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">20.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">or/12-19</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">21.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">4 not 20</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">22.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">limit 21 to English language</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">23.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">health economics/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">24.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp economic evaluation/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">25.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp health care cost/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">26.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp fee/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">27.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">budget/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">28.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">funding/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">29.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">budget*.ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">30.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">cost*.ti.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">31.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(economic* or pharmaco?economic*).ti.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">32.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(price* or pricing*).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">33.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(cost* adj2 (effective* or utilit* or benefit* or minimi* or unit* or estimat* or variable*)).ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">34.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(financ* or fee or fees).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">35.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(value adj2 (money or monetary)).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">36.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">or/23-35</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">37.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">22 and 36</td></tr></tbody></table></div></div></article><article data-type="table-wrap" id="figobniceng157er8appbtab8"><div id="niceng157er8.appb.tab8" class="table"><h3><span class="title">NHS EED and HTA (CRD) search terms</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK561387/table/niceng157er8.appb.tab8/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__niceng157er8.appb.tab8_lrgtbl__"><table><tbody><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#1.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MeSH DESCRIPTOR arthroplasty</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#2.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MeSH DESCRIPTOR arthroplasty, replacement</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#3.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MeSH DESCRIPTOR arthroplasty, replacement, hip</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#4.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MeSH DESCRIPTOR arthroplasty, replacement, knee</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#5.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MeSH DESCRIPTOR arthroplasty, replacement, shoulder</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#6.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MeSH DESCRIPTOR hemiarthroplasty</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#7.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MeSH DESCRIPTOR joint prosthesis</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#8.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MeSH DESCRIPTOR hip prosthesis</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#9.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MeSH DESCRIPTOR knee prosthesis</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#10.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MeSH DESCRIPTOR shoulder prosthesis</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#11.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(((joint* or knee* or shoulder* or hip*) adj5 (surger* or replace* or prosthe* or endoprosthe* or implant* or artificial or arthroplast* or hemiarthroplast*)))</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#12.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(#1 OR #2 OR #3 OR #4 OR #5 OR #6 OR #7 OR #8 OR #9 OR #10 OR #11) IN NHSEED</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#13.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(#1 OR #2 OR #3 OR #4 OR #5 OR #6 OR #7 OR #8 OR #9 OR #10 OR #11) IN HTA</td></tr></tbody></table></div></div></article><article data-type="fig" id="figobniceng157er8appcfig1"><div id="niceng157er8.appc.fig1" class="figure bk_fig"><div class="graphic"><a href="/core/lw/2.0/html/tileshop_pmc/tileshop_pmc_inline.html?title=Figure%201.%20Flow%20chart%20of%20clinical%20study%20selection%20for%20the%20review%20of%20wound%20lavage.&p=BOOKS&id=561387_niceng157er8appcf1.jpg" target="tileshopwindow" class="inline_block pmc_inline_block ts_canvas img_link" title="Click on image to zoom"><div class="ts_bar small" title="Click on image to zoom"></div><img data-src="/books/NBK561387/bin/niceng157er8appcf1.jpg" alt="Figure 1. Flow chart of clinical study selection for the review of wound lavage." class="tileshop" title="Click on image to zoom" /></a></div><h3><span class="label">Figure 1</span><span class="title">Flow chart of clinical study selection for the review of wound lavage</span></h3></div></article><article data-type="fig" id="figobniceng157er8appdfig1"><div id="niceng157er8.appd.fig1" class="figure bk_fig"><div class="graphic"><a href="/core/lw/2.0/html/tileshop_pmc/tileshop_pmc_inline.html?title=Figure%202.%20Flow%20chart%20of%20health%20economic%20study%20selection%20for%20the%20guideline.&p=BOOKS&id=561387_niceng157er8appdf1.jpg" target="tileshopwindow" class="inline_block pmc_inline_block ts_canvas img_link" title="Click on image to zoom"><div class="ts_bar small" title="Click on image to zoom"></div><img data-src="/books/NBK561387/bin/niceng157er8appdf1.jpg" alt="Figure 2. Flow chart of health economic study selection for the guideline." class="tileshop" title="Click on image to zoom" /></a></div><h3><span class="label">Figure 2</span><span class="title">Flow chart of health economic study selection for the guideline</span></h3><div class="caption"><p>a) Non-relevant population, intervention, comparison, design or setting; non-English language</p><p>b) One study was applicable to both Q3.1 and Q3.2</p></div></div></article><article data-type="table-wrap" id="figobniceng157er8appetab1"><div id="niceng157er8.appe.tab1" class="table"><h3><span class="label">Table 8</span><span class="title">Studies excluded from the clinical review</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK561387/table/niceng157er8.appe.tab1/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__niceng157er8.appe.tab1_lrgtbl__"><table><thead><tr><th id="hd_h_niceng157er8.appe.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Study</th><th id="hd_h_niceng157er8.appe.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Exclusion reason</th></tr></thead><tbody><tr><td headers="hd_h_niceng157er8.appe.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Abdelaziz 2019<a class="bibr" href="#niceng157er8.ref1" rid="niceng157er8.ref1"><sup>1</sup></a></td><td headers="hd_h_niceng157er8.appe.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Incorrect interventions</td></tr><tr><td headers="hd_h_niceng157er8.appe.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Abdeldayem 2018<a class="bibr" href="#niceng157er8.ref2" rid="niceng157er8.ref2"><sup>2</sup></a></td><td headers="hd_h_niceng157er8.appe.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Inappropriate comparison</td></tr><tr><td headers="hd_h_niceng157er8.appe.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Anglen 2005<a class="bibr" href="#niceng157er8.ref3" rid="niceng157er8.ref3"><sup>3</sup></a></td><td headers="hd_h_niceng157er8.appe.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Incorrect population</td></tr><tr><td headers="hd_h_niceng157er8.appe.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Anon 2001<a class="bibr" href="#niceng157er8.ref4" rid="niceng157er8.ref4"><sup>4</sup></a></td><td headers="hd_h_niceng157er8.appe.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Literature review</td></tr><tr><td headers="hd_h_niceng157er8.appe.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Capito 2017<a class="bibr" href="#niceng157er8.ref5" rid="niceng157er8.ref5"><sup>5</sup></a></td><td headers="hd_h_niceng157er8.appe.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Incorrect interventions. Not review population</td></tr><tr><td headers="hd_h_niceng157er8.appe.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Chung 2019<a class="bibr" href="#niceng157er8.ref6" rid="niceng157er8.ref6"><sup>6</sup></a></td><td headers="hd_h_niceng157er8.appe.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Incorrect interventions</td></tr><tr><td headers="hd_h_niceng157er8.appe.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Cobden 2019<a class="bibr" href="#niceng157er8.ref7" rid="niceng157er8.ref7"><sup>7</sup></a></td><td headers="hd_h_niceng157er8.appe.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Incorrect study design</td></tr><tr><td headers="hd_h_niceng157er8.appe.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Cohen 2019<a class="bibr" href="#niceng157er8.ref8" rid="niceng157er8.ref8"><sup>8</sup></a></td><td headers="hd_h_niceng157er8.appe.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Observational study not suitably adjusted for confounders</td></tr><tr><td headers="hd_h_niceng157er8.appe.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Ennin 2012<a class="bibr" href="#niceng157er8.ref9" rid="niceng157er8.ref9"><sup>9</sup></a></td><td headers="hd_h_niceng157er8.appe.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Incorrect study design. Not review population</td></tr><tr><td headers="hd_h_niceng157er8.appe.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Fei 2011<a class="bibr" href="#niceng157er8.ref10" rid="niceng157er8.ref10"><sup>10</sup></a></td><td headers="hd_h_niceng157er8.appe.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Inappropriate comparison</td></tr><tr><td headers="hd_h_niceng157er8.appe.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Fernicola 2019<a class="bibr" href="#niceng157er8.ref11" rid="niceng157er8.ref11"><sup>11</sup></a></td><td headers="hd_h_niceng157er8.appe.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Systematic review: included studies checked for this review</td></tr><tr><td headers="hd_h_niceng157er8.appe.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Frisch 2017<a class="bibr" href="#niceng157er8.ref12" rid="niceng157er8.ref12"><sup>12</sup></a></td><td headers="hd_h_niceng157er8.appe.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Observational study: no adjustment for confounding factors</td></tr><tr><td headers="hd_h_niceng157er8.appe.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Gupta 2016<a class="bibr" href="#niceng157er8.ref13" rid="niceng157er8.ref13"><sup>13</sup></a></td><td headers="hd_h_niceng157er8.appe.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Incorrect interventions</td></tr><tr><td headers="hd_h_niceng157er8.appe.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Heckmann 2019<a class="bibr" href="#niceng157er8.ref14" rid="niceng157er8.ref14"><sup>14</sup></a></td><td headers="hd_h_niceng157er8.appe.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Systematic review: included studies checked for this review</td></tr><tr><td headers="hd_h_niceng157er8.appe.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Kantak 2017<a class="bibr" href="#niceng157er8.ref16" rid="niceng157er8.ref16"><sup>16</sup></a></td><td headers="hd_h_niceng157er8.appe.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Inappropriate comparison</td></tr><tr><td headers="hd_h_niceng157er8.appe.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Kok 1998<a class="bibr" href="#niceng157er8.ref17" rid="niceng157er8.ref17"><sup>17</sup></a></td><td headers="hd_h_niceng157er8.appe.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Unavailable</td></tr><tr><td headers="hd_h_niceng157er8.appe.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Lin 2018<a class="bibr" href="#niceng157er8.ref18" rid="niceng157er8.ref18"><sup>18</sup></a></td><td headers="hd_h_niceng157er8.appe.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Unavailable</td></tr><tr><td headers="hd_h_niceng157er8.appe.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Lortat-jacob 1994<a class="bibr" href="#niceng157er8.ref19" rid="niceng157er8.ref19"><sup>19</sup></a></td><td headers="hd_h_niceng157er8.appe.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not in English</td></tr><tr><td headers="hd_h_niceng157er8.appe.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Memon 2018<a class="bibr" href="#niceng157er8.ref20" rid="niceng157er8.ref20"><sup>20</sup></a></td><td headers="hd_h_niceng157er8.appe.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Incorrect interventions</td></tr><tr><td headers="hd_h_niceng157er8.appe.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Mont 2000<a class="bibr" href="#niceng157er8.ref21" rid="niceng157er8.ref21"><sup>21</sup></a></td><td headers="hd_h_niceng157er8.appe.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Incorrect interventions</td></tr><tr><td headers="hd_h_niceng157er8.appe.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Mortada 2012<a class="bibr" href="#niceng157er8.ref22" rid="niceng157er8.ref22"><sup>22</sup></a></td><td headers="hd_h_niceng157er8.appe.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Unavailable</td></tr><tr><td headers="hd_h_niceng157er8.appe.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Moseley 1996<a class="bibr" href="#niceng157er8.ref23" rid="niceng157er8.ref23"><sup>23</sup></a></td><td headers="hd_h_niceng157er8.appe.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Incorrect population</td></tr><tr><td headers="hd_h_niceng157er8.appe.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Norman 2017<a class="bibr" href="#niceng157er8.ref27" rid="niceng157er8.ref27"><sup>27</sup></a></td><td headers="hd_h_niceng157er8.appe.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Incorrect population</td></tr><tr><td headers="hd_h_niceng157er8.appe.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Riesgo 2018<a class="bibr" href="#niceng157er8.ref28" rid="niceng157er8.ref28"><sup>28</sup></a></td><td headers="hd_h_niceng157er8.appe.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Incorrect population</td></tr><tr><td headers="hd_h_niceng157er8.appe.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Shah 2019<a class="bibr" href="#niceng157er8.ref29" rid="niceng157er8.ref29"><sup>29</sup></a></td><td headers="hd_h_niceng157er8.appe.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Inappropriate comparison</td></tr><tr><td headers="hd_h_niceng157er8.appe.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Sneath 2001<a class="bibr" href="#niceng157er8.ref30" rid="niceng157er8.ref30"><sup>30</sup></a></td><td headers="hd_h_niceng157er8.appe.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Incorrect interventions</td></tr><tr><td headers="hd_h_niceng157er8.appe.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Sultan 2019<a class="bibr" href="#niceng157er8.ref31" rid="niceng157er8.ref31"><sup>31</sup></a></td><td headers="hd_h_niceng157er8.appe.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Systematic review: included studies checked for this review</td></tr><tr><td headers="hd_h_niceng157er8.appe.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Teeny 1990<a class="bibr" href="#niceng157er8.ref32" rid="niceng157er8.ref32"><sup>32</sup></a></td><td headers="hd_h_niceng157er8.appe.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not review population</td></tr><tr><td headers="hd_h_niceng157er8.appe.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Timperley 2009<a class="bibr" href="#niceng157er8.ref33" rid="niceng157er8.ref33"><sup>33</sup></a></td><td headers="hd_h_niceng157er8.appe.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Incorrect study design</td></tr><tr><td headers="hd_h_niceng157er8.appe.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Triantafyllopoulos 2015<a class="bibr" href="#niceng157er8.ref34" rid="niceng157er8.ref34"><sup>34</sup></a></td><td headers="hd_h_niceng157er8.appe.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Incorrect interventions</td></tr><tr><td headers="hd_h_niceng157er8.appe.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Turhan 2019<a class="bibr" href="#niceng157er8.ref35" rid="niceng157er8.ref35"><sup>35</sup></a></td><td headers="hd_h_niceng157er8.appe.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Incorrect interventions</td></tr><tr><td headers="hd_h_niceng157er8.appe.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Weenders 2016<a class="bibr" href="#niceng157er8.ref36" rid="niceng157er8.ref36"><sup>36</sup></a></td><td headers="hd_h_niceng157er8.appe.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Incorrect interventions</td></tr><tr><td headers="hd_h_niceng157er8.appe.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Wintzell 1999<a class="bibr" href="#niceng157er8.ref37" rid="niceng157er8.ref37"><sup>37</sup></a></td><td headers="hd_h_niceng157er8.appe.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not review population. Inappropriate comparison</td></tr><tr><td headers="hd_h_niceng157er8.appe.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Wong 2009<a class="bibr" href="#niceng157er8.ref38" rid="niceng157er8.ref38"><sup>38</sup></a></td><td headers="hd_h_niceng157er8.appe.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Incorrect population</td></tr><tr><td headers="hd_h_niceng157er8.appe.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Yazdi 2014<a class="bibr" href="#niceng157er8.ref39" rid="niceng157er8.ref39"><sup>39</sup></a></td><td headers="hd_h_niceng157er8.appe.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Incorrect population</td></tr><tr><td headers="hd_h_niceng157er8.appe.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Zhao 2015<a class="bibr" href="#niceng157er8.ref40" rid="niceng157er8.ref40"><sup>40</sup></a></td><td headers="hd_h_niceng157er8.appe.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Inappropriate comparison</td></tr></tbody></table></div></div></article></div><div id="jr-scripts"><script src="/corehtml/pmc/jatsreader/ptpmc_3.22/js/libs.min.js"> </script><script src="/corehtml/pmc/jatsreader/ptpmc_3.22/js/jr.min.js"> </script></div></div>
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