{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,16]],"date-time":"2026-05-16T06:11:22Z","timestamp":1778911882698,"version":"3.51.4"},"reference-count":44,"publisher":"SAGE Publications","issue":"5","license":[{"start":{"date-parts":[[2026,1,31]],"date-time":"2026-01-31T00:00:00Z","timestamp":1769817600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Vasc Endovascular Surg"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Surgical site infection (SSI) following transmetatarsal amputation (TMA) is thought to be common. In patients who have peripheral arterial disease (PAD) or diabetes related foot complications, little is known regarding the effectiveness of interventions designed to reduce SSI following TMA. Our aim was to perform a systematic review of the literature to inform practice and highlight areas that warrant further research to reduce SSI post TMA.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This review was performed using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidance and was prospectively registered with the International Prospective Register of Systematic Reviews (CRD4202454958). MEDLINE, EMBASE and Cochrane databases were searched using a predefined search strategy, without date restriction. All randomised controlled trials (RCTs) and observational studies including patients that underwent TMA due to PAD or complications of diabetes related foot disease, with at least 1 intervention designed to promote wound healing or reduce SSI were included. Bias was assessed using the Cochrane Risk of Bias Tool and the Newcastle-Ottawa Scale.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The initial search identified 445 papers. Two RCTs and three observational studies, reporting on 378 TMAs and four interventions, were included. The effect of post-operative antibiotic use on the incidence of SSI differed between the studies. The use of antibiotic-impregnated beads embedded within the soft tissues prior to wound closure were associated with a reduction in SSI rate. The use of Negative Pressure Wound Therapy (NPWT) was associated with a reduction in SSI incidence and faster wound healing. No significant difference was identified in the incidence of SSI between different skin preparations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Data regarding interventions to prevent SSI following TMA are sparse in the current literature. Prolonged post-operative antibiotic use could reduce SSI, while NPWT and antibiotic beads may be beneficial to wound healing. However, larger more robust RCTs are required to confirm these findings.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/15385744261421787","type":"journal-article","created":{"date-parts":[[2026,1,31]],"date-time":"2026-01-31T15:55:49Z","timestamp":1769874949000},"page":"411-419","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["A Systematic Review of Interventions Designed to Reduce Surgical Site Infection in Patients Who Undergo Transmetatarsal Amputation"],"prefix":"10.1177","volume":"60","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-1186-7008","authenticated-orcid":false,"given":"Rebecca","family":"Jess","sequence":"first","affiliation":[{"name":"Russell\u2019s Hall Hospital"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kieran","family":"Das","sequence":"additional","affiliation":[{"name":"Russell\u2019s Hall Hospital"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lakna Harindi","family":"Alawattegama","sequence":"additional","affiliation":[{"name":"Russell\u2019s Hall Hospital"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nina","family":"Al-Saadi","sequence":"additional","affiliation":[{"name":"Russell\u2019s Hall Hospital"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David","family":"Bosanquet","sequence":"additional","affiliation":[{"name":"South East Wales Vascular Network, Cardiff and Vale Health Board, Cardiff, Wales"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ian","family":"Chetter","sequence":"additional","affiliation":[{"name":"University of Hull"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ismay","family":"Fabre","sequence":"additional","affiliation":[{"name":"South East Wales Vascular Network, Cardiff and Vale Health Board, Cardiff, Wales"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrew","family":"Garnham","sequence":"additional","affiliation":[{"name":"Russell\u2019s Hall Hospital"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Brenig","family":"Gwilym","sequence":"additional","affiliation":[{"name":"South East Wales Vascular Network, Cardiff and Vale Health Board, Cardiff, Wales"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Louise","family":"Hitchman","sequence":"additional","affiliation":[{"name":"University of Hull"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Terry","family":"Hughes","sequence":"additional","affiliation":[{"name":"University of Birmingham"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Judith","family":"Long","sequence":"additional","affiliation":[{"name":"University of Hull"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Laura","family":"Magill","sequence":"additional","affiliation":[{"name":"University of Birmingham"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thomas","family":"Pinkney","sequence":"additional","affiliation":[{"name":"University of Birmingham"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6239-4039","authenticated-orcid":false,"given":"Matthew","family":"Popplewell","sequence":"additional","affiliation":[{"name":"Russell\u2019s Hall Hospital"},{"name":"University of Birmingham"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael","family":"Wall","sequence":"additional","affiliation":[{"name":"Russell\u2019s Hall Hospital"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2026,1,31]]},"reference":[{"key":"e_1_3_6_2_2","doi-asserted-by":"publisher","DOI":"10.1097\/00000658-194910000-00019"},{"key":"e_1_3_6_3_2","doi-asserted-by":"publisher","DOI":"10.1155\/2012\/797218"},{"key":"e_1_3_6_4_2","doi-asserted-by":"publisher","DOI":"10.1093\/ptj\/77.9.937"},{"key":"e_1_3_6_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jss.2019.07.003"},{"key":"e_1_3_6_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejvs.2012.01.029"},{"key":"e_1_3_6_7_2","doi-asserted-by":"publisher","DOI":"10.54522\/jvsgbi.2024.139"},{"key":"e_1_3_6_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.foot.2009.07.005"},{"key":"e_1_3_6_9_2","unstructured":"Vascular Services Quality Improvement Programme. National vascular registry. 2025. [cited 2025 Mar 22]. Available from: https:\/\/www.vsqip.org.uk\/"},{"key":"e_1_3_6_10_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1000097"},{"key":"e_1_3_6_11_2","article-title":"The incidence of surgical site infections following interventions used in transmetatarsal amputations","author":"Jess R","year":"2024","unstructured":"Jess R, Wall M, Popplewell M, Al-Saadi N, Chetter I. The incidence of surgical site infections following interventions used in transmetatarsal amputations. A systematic review. 2024. [cited 2025 Mar 22]. Available from: https:\/\/www.crd.york.ac.uk\/PROSPERO\/view\/CRD42024549585","journal-title":"A systematic review"},{"key":"e_1_3_6_12_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.l4898"},{"key":"e_1_3_6_13_2","unstructured":"Wells G Shea B O\u2019Connell D et al. The Newcastle\u2013Ottawa scale (NOS) for assessing the quality of non-randomized studies in meta-analysis. 2000. available at. https:\/\/www.ohri.ca\/programs\/clinical_epidemiology\/oxford.asp. Accessed November 2024."},{"key":"e_1_3_6_14_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.328.7454.1490"},{"key":"e_1_3_6_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/s0140-6736(86)90838-x"},{"key":"e_1_3_6_16_2","doi-asserted-by":"publisher","DOI":"10.1177\/2292550319826095"},{"key":"e_1_3_6_17_2","unstructured":"CDC: Centers for Disease Control and Prevention. Patient safety component (PSC). 2024. [cited 2025 Mar 22]. Available from: https:\/\/www.cdc.gov\/nhsn\/psc\/index.html"},{"key":"e_1_3_6_18_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(05)67695-7"},{"key":"e_1_3_6_19_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00776-012-0245-5"},{"key":"e_1_3_6_20_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.avsg.2012.02.011"},{"key":"e_1_3_6_21_2","doi-asserted-by":"publisher","DOI":"10.3113\/FAI.2009.0486"},{"key":"e_1_3_6_22_2","doi-asserted-by":"publisher","DOI":"10.1093\/bjs\/znac053"},{"key":"e_1_3_6_23_2","unstructured":"NHS England. Hospital admitted patient care activity 2022 [Internet]. 2023 [cited 2025 Mar 22]. Available from: https:\/\/digital.nhs.uk\/data-and-information\/publications\/statistical\/hospital-admitted-patient-care-activity\/2022-23"},{"key":"e_1_3_6_24_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2020.07.086"},{"key":"e_1_3_6_25_2","doi-asserted-by":"publisher","DOI":"10.1053\/j.jfas.2018.03.047"},{"key":"e_1_3_6_26_2","doi-asserted-by":"publisher","DOI":"10.1177\/000313480607201030"},{"key":"e_1_3_6_27_2","doi-asserted-by":"publisher","DOI":"10.1097\/GOX.0000000000004350"},{"key":"e_1_3_6_28_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.avsg.2023.05.026"},{"key":"e_1_3_6_29_2","doi-asserted-by":"publisher","DOI":"10.54522\/jvsgbi.2021.001"},{"key":"e_1_3_6_30_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(25)00143-6"},{"key":"e_1_3_6_31_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jor.2020.09.005"},{"key":"e_1_3_6_32_2","doi-asserted-by":"publisher","DOI":"10.1308\/rcsann.2023.0011"},{"key":"e_1_3_6_33_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2020.07.061"},{"key":"e_1_3_6_34_2","doi-asserted-by":"publisher","DOI":"10.1002\/jbm.b.31275"},{"key":"e_1_3_6_35_2","doi-asserted-by":"publisher","DOI":"10.5402\/2011\/290851"},{"key":"e_1_3_6_36_2","doi-asserted-by":"publisher","DOI":"10.1002\/edm2.59"},{"key":"e_1_3_6_37_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejvs.2007.07.016"},{"key":"e_1_3_6_38_2","doi-asserted-by":"publisher","DOI":"10.1093\/jacamr\/dlae217.010"},{"key":"e_1_3_6_39_2","doi-asserted-by":"publisher","DOI":"10.1177\/1938640014560162"},{"key":"e_1_3_6_40_2","doi-asserted-by":"publisher","DOI":"10.1016\/S2214-109X(23)00538-7"},{"key":"e_1_3_6_41_2","doi-asserted-by":"publisher","DOI":"10.1177\/24730114221112938"},{"key":"e_1_3_6_42_2","doi-asserted-by":"publisher","DOI":"10.3113\/FAI.2009.1177"},{"key":"e_1_3_6_43_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2016.08.078"},{"key":"e_1_3_6_44_2","doi-asserted-by":"publisher","DOI":"10.54522\/jvsgbi.2022.030"},{"key":"e_1_3_6_45_2","doi-asserted-by":"publisher","DOI":"10.1111\/iwj.13526"}],"container-title":["Vascular and Endovascular Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/15385744261421787","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/15385744261421787","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/15385744261421787","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,16]],"date-time":"2026-05-16T05:43:08Z","timestamp":1778910188000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/15385744261421787"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1,31]]},"references-count":44,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2026,7]]}},"alternative-id":["10.1177\/15385744261421787"],"URL":"https:\/\/doi.org\/10.1177\/15385744261421787","relation":{},"ISSN":["1538-5744","1938-9116"],"issn-type":[{"value":"1538-5744","type":"print"},{"value":"1938-9116","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1,31]]}}}