Xu Bin, Xu Bo, Wang Liwei, Chen Chunqiu, Yilmaz Tonguç Utku, Zheng Wenyan, He Bin
From the *Department of General Surgery, Shanghai Tenth People's Hospital, Tongji University School of Medicine; †Department of Anesthesiology and SICU, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai; ‡Department of Medical Informatics, School of Public Health, Jilin University, Changchun, Jilin, China; §Department of General Surgery, Kocaeli University School of Medicine, Kocaeli, Turkey; and ∥Department of Surgical Intensive Care Unit, Zhong Shan Hospital, Fudan University, Shanghai, China.
Ann Plast Surg. 2016 May;76(5):598-606. doi: 10.1097/SAP.0000000000000418.
Prior studies focused on skin closure using absorbable or nonabsorbable sutures involved small samples and produced conflicting results. The optimal method of skin closure still remains unclear.
This study aimed to compare the outcomes of absorbable versus nonabsorbable sutures for skin closure.
A meta-analysis was performed in randomized controlled trials (RCTs) that compared outcomes of absorbable versus nonabsorbable sutures for skin closure.
A total of 1748 patients in 19 RCTs were analyzed. There was no significant difference between absorbable sutures and nonabsorbable sutures in the incidence of wound infections, cosmetic outcomes, scar formation, wound dehiscence, and patients' or patient caregivers' satisfaction. Better cosmetic results were achieved by using intradermal absorbable sutures compared with nonabsorbable sutures in subgroup analysis, but this result might be affected by insufficient follow-ups.
Absorbable sutures for skin closure were not inferior to nonabsorbable sutures. It should be recommended due to its great cost and time savings. Well-designed RCTs with sufficient follow-ups are needed to adequately clarify whether better cosmetic results can be achieved using intradermal absorbable sutures.
先前关于使用可吸收或不可吸收缝线进行皮肤缝合的研究样本量较小,结果相互矛盾。皮肤缝合的最佳方法仍不明确。
本研究旨在比较可吸收缝线与不可吸收缝线用于皮肤缝合的效果。
对比较可吸收缝线与不可吸收缝线用于皮肤缝合效果的随机对照试验进行荟萃分析。
共分析了19项随机对照试验中的1748例患者。在伤口感染发生率、美容效果、瘢痕形成、伤口裂开以及患者或患者护理人员的满意度方面,可吸收缝线与不可吸收缝线之间无显著差异。亚组分析显示,与不可吸收缝线相比,使用皮内可吸收缝线可获得更好的美容效果,但这一结果可能受到随访不足的影响。
用于皮肤缝合的可吸收缝线并不劣于不可吸收缝线。因其能大幅节省成本和时间,故应予以推荐。需要设计良好且随访充分的随机对照试验,以充分阐明使用皮内可吸收缝线是否能获得更好的美容效果。