Gkegkes Ioannis D, Mavros Michael N, Alexiou Vangelis G, Peppas George, Athanasiou Stavros, Falagas Matthew E
Alfa Institute of Biomedical Sciences, Athens, Greece.
Surg Innov. 2012 Jun;19(2):145-55. doi: 10.1177/1553350611418989. Epub 2011 Sep 16.
The authors evaluated the available evidence regarding the use of adhesive strips for the management of surgical incisions and compared them with sutures and other closure materials. Study design. Systematic review and meta-analysis of randomized controlled trials (RCTs).
Twelve RCTs studying 1317 incisions in 1023 patients were included. No difference was found regarding the development of infection (odds ratio [OR] = 0.47; 95% Confidence interval [CI] = 0.12-1.85), dehiscence (OR = 1.22; 95% CI = 0.32-4.64), and overall cosmetic result (standardized mean difference = 0.01; 95% CI = -0.19 to 0.20). Closure with strips resulted in significantly lower incidence of redness (OR = 0.57; 95% CI = 0.37-0.89). The available data on pain, need for resuturing, swelling, patient satisfaction, and closure time with the use of strips could not be synthesized; however, regarding the latter 2 outcomes, application of strips seemed favorable. There was significant heterogeneity among the studies.
The findings suggest that adhesive strips may be an efficient closure material for certain small-length incisions. Further research is warranted on outcomes such as dehiscence and the need for resuturing.
作者评估了关于使用粘合带处理手术切口的现有证据,并将其与缝线及其他闭合材料进行比较。研究设计:对随机对照试验(RCT)进行系统评价和荟萃分析。
纳入了12项研究1023例患者1317处切口的随机对照试验。在感染发生率(优势比[OR]=0.47;95%置信区间[CI]=0.12-1.85)、切口裂开(OR=1.22;95%CI=0.32-4.64)及总体美容效果(标准化均数差=0.01;95%CI=-0.19至0.20)方面未发现差异。使用粘合带闭合导致发红发生率显著降低(OR=0.57;95%CI=0.37-0.89)。关于疼痛、再次缝合需求、肿胀、患者满意度及使用粘合带的闭合时间的现有数据无法进行综合分析;然而,就后两项结果而言,使用粘合带似乎更有利。各研究之间存在显著异质性。
研究结果表明,粘合带可能是某些小长度切口的一种有效闭合材料。对于切口裂开和再次缝合需求等结果,有必要进行进一步研究。