Giordano Salvatore, Koskivuo Ilkka, Suominen Erkki, Veräjänkorva Esko
Department of Plastic and General Surgery, Turku University Hospital, Turku, Finland; Department of Surgery, Welfare District of Forssa, Forssa, Finland.
Department of Plastic and General Surgery, Turku University Hospital, Turku, Finland.
J Plast Reconstr Aesthet Surg. 2017 Mar;70(3):297-306. doi: 10.1016/j.bjps.2016.11.028. Epub 2016 Dec 15.
The use of tissue sealants has increased among different surgical specialities. Face-lift and rhytidoplasty may cause several complications such as haematoma, ecchymosis, oedema, seroma, skin necrosis, wound dehiscence and wound infection. However, administration of tissue sealants may prevent the occurrence of some complications. We performed a meta-analysis of studies that compared tissue sealant use with controls to evaluate the outcomes. A systematic literature search was performed. The primary outcome was the incidence of haematoma. Secondary outcomes were wound drainage amount, oedema, ecchymosis, seroma, skin necrosis and hypertrophic scarring. Thirteen studies involving 2434 patients were retrieved and included in the present analysis. A statistically significantly decrease in post-operative haematoma [risk ratio (RR), 0.37; 95% CI, 0.18-0.74; p = 0.005] and wound drainage (MD, -16.90, 95% CI = -25.71, -8.08, p < 0.001) was observed with tissue sealant use. A significant decrease in oedema was detected (RR, 0.30; 95% CI, 0.11-0.85, p = 0.02) but not in ecchymosis, seroma, skin necrosis, and hypertrophic scarring with tissue sealant use. The use of tissue sealants prevents post-operative haematomas and reduces wound drainage. Previous studies have shown a similar trend, but the power of this meta-analysis could verify this perception.
III.
组织密封剂在不同外科专科中的使用有所增加。面部提升术和除皱术可能会引发多种并发症,如血肿、瘀斑、水肿、血清肿、皮肤坏死、伤口裂开和伤口感染。然而,使用组织密封剂可能会预防某些并发症的发生。我们对比较使用组织密封剂与对照组的研究进行了荟萃分析,以评估结果。进行了系统的文献检索。主要结局是血肿的发生率。次要结局包括伤口引流量、水肿、瘀斑、血清肿、皮肤坏死和增生性瘢痕形成。检索到13项涉及2434例患者的研究并纳入本分析。使用组织密封剂后,术后血肿[风险比(RR),0.37;95%置信区间(CI),0.18 - 0.74;p = 0.005]和伤口引流(平均差,-16.90,95% CI = -25.71,-8.08,p < 0.001)在统计学上显著降低。检测到水肿显著降低(RR,0.30;95% CI,0.11 - 0.85,p = 0.02),但使用组织密封剂后瘀斑、血清肿、皮肤坏死和增生性瘢痕形成未显著降低。使用组织密封剂可预防术后血肿并减少伤口引流。先前的研究已显示出类似趋势,但本荟萃分析的效能能够证实这一观点。
III。