Por Yong-Chen, Shi Luming, Samuel Miny, Song Colin, Yeow Vincent Kok-Leng
Department of Plastic, Reconstructive and Aesthetic Surgery, Kandang Kerbau Women's and Children's Hospital, Singapore, Singapore.
Aesthetic Plast Surg. 2009 May;33(3):336-9. doi: 10.1007/s00266-008-9280-1. Epub 2008 Dec 17.
This review sought to determine the efficacy of tissue sealants such as fibrin tissue adhesives and platelet-rich plasma in reducing postoperative drainage, ecchymosis, and edema after face-lift surgery.
The electronic databases MEDLINE (1966-May 2007) and EMBASE (1974-May 2007) and the Cochrane Central Register of Controlled Trials (CENTRAL) were searched for human studies, randomized controlled trials, controlled clinical trials, metaanalyses, and reviews of randomized controlled trials using the key words "fibrin tissue adhesive," "tissue sealant," "platelet-rich plasma," "face-lift," "rhytidoplasty," "rhytidectomy," and "facial plastic surgery." The search yielded 10 articles, only 3 of which met our inclusion criteria. The three studies were within-patient comparisons (patients acted as their own controls).
Although not statistically significant, the pooled results showed a strong trend toward reduction in postoperative drainage at 24 h and ecchymosis with the use of tissue sealants compared with the control arm of the study. No difference in outcomes was observed between the tissue sealant and control arms of the study in terms of postoperative edema measurement.
There was no statistically significant benefit from the use of tissue sealants in face-lift surgery. However, tissue sealants may be useful for patients at a high risk for hematoma and ecchymosis formation.
本综述旨在确定纤维蛋白组织粘合剂和富血小板血浆等组织密封剂在减少面部提升手术后的术后引流、瘀斑和水肿方面的疗效。
检索电子数据库MEDLINE(1966年至2007年5月)、EMBASE(1974年至2007年5月)以及Cochrane对照试验中央注册库(CENTRAL),以查找使用关键词“纤维蛋白组织粘合剂”、“组织密封剂”、“富血小板血浆”、“面部提升”、“除皱术”、“除皱切除术”和“面部整形手术”的人体研究、随机对照试验、对照临床试验、荟萃分析以及随机对照试验综述。检索结果为10篇文章,其中只有3篇符合我们的纳入标准。这三项研究为患者自身对照比较(患者自身作为对照)。
尽管无统计学意义,但汇总结果显示,与研究的对照组相比,使用组织密封剂在术后24小时减少术后引流以及减少瘀斑方面有明显趋势。在术后水肿测量方面,研究的组织密封剂组和对照组之间未观察到结果差异。
在面部提升手术中使用组织密封剂无统计学意义上的显著益处。然而,组织密封剂可能对有血肿和瘀斑形成高风险的患者有用。