Sadhra S S, Motahariasl S, Hardwicke J T
College of Medical and Dental Sciences, University of Birmingham, Edgbaston, Birmingham B15 2TT, United Kingdom.
Warwick Medical School, The University of Warwick, Coventry CV4 7AL, United Kingdom; Department of Plastic Surgery, University Hospitals of Coventry and Warwickshire NHS Trust, Clifford Bridge Road, Coventry, CV2 2DX, United Kingdom.
J Plast Reconstr Aesthet Surg. 2017 Aug;70(8):1083-1090. doi: 10.1016/j.bjps.2017.05.033. Epub 2017 May 20.
There is great diversity in reported post-operative outcomes for otoplasty, with the incidence of haematoma or infection ranging from 0% to 15.6% and 0%-10%, respectively. With such variability, it is difficult to determine an overall 'average' incidence of common post-operative complications.
A systematic review of the most relevant medical databases was conducted for studies available in English published between January 1, 2000, and December 31, 2015. Using the dataset, pooled estimates for the incidence of the primary and secondary outcomes were calculated for all included studies. The primary outcome was haematoma and/or bleeding incidence, and the secondary outcomes included infection, skin/wound healing problems, suture-related problems, scarring, pain and itching, and revision surgeries/recurrence. Comparable sub-group analysis of studies was also performed using calculated pooled proportions.
After screening, 28 articles involving 3493 patients were included in the study. Pooled proportions revealed that haematoma and/or bleeding incidence was 2.5% (95% CI: 1.4-3.8%), infection 0.8% (95% CI: 0.4-1.3%), skin/wound healing problems 3% (95% CI: 1.4-5.1%), suture-related problems 1.8% (95% CI: 0.8-3.2%), scarring 1.6% (95% CI: 0.8-2.6%), pain and itching 13% (95% CI: 5.4-23.1%) and revision surgeries/recurrence 5% (95% CI: 2.9-7.7%).
By pooling proportions of reported complications, the results of this study could be useful in the personal audit of practice and will be a point of reference for comparing novel surgical techniques in the future.
关于耳整形术后结果的报道差异很大,血肿或感染的发生率分别为0%至15.6%和0%至10%。存在如此大的变异性,很难确定常见术后并发症的总体“平均”发生率。
对最相关的医学数据库进行系统回顾,以查找2000年1月1日至2015年12月31日期间发表的英文研究。使用该数据集,计算所有纳入研究的主要和次要结果发生率的合并估计值。主要结果是血肿和/或出血发生率,次要结果包括感染、皮肤/伤口愈合问题、缝线相关问题、瘢痕形成、疼痛和瘙痒,以及翻修手术/复发。还使用计算出的合并比例对研究进行了可比亚组分析。
筛选后,该研究纳入了28篇涉及3493例患者的文章。合并比例显示,血肿和/或出血发生率为2.5%(95%CI:1.4 - 3.8%),感染为0.8%(95%CI:0.4 - 1.3%),皮肤/伤口愈合问题为3%(95%CI:1.4 - 5.1%),缝线相关问题为1.8%(95%CI:0.8 - 3.2%),瘢痕形成为1.6%(95%CI:0.8 - 2.6%),疼痛和瘙痒为13%(95%CI:5.4 - 23.1%),翻修手术/复发为5%(95%CI:2.9 - 7.7%)。
通过汇总报道并发症的比例,本研究结果可用于个人实践审核,并将成为未来比较新型手术技术的参考点。