Hörmann Julie, Vach Werner, Jakob Marcel, Seghers Saskia, Saxer Franziska
1Department of Orthopaedic and Trauma Surgery, University Hospital Basel, Basel, Switzerland.
Crossklinik AG Swiss Olympic Medical Centre, Basel, Switzerland.
BMC Sports Sci Med Rehabil. 2020 Mar 2;12:14. doi: 10.1186/s13102-020-00162-3. eCollection 2020.
Postoperative oedema is a common condition affecting wound healing and function. Traditionally, manual lymphatic drainage is employed to reduce swelling. Kinesiotaping might be an alternative resource-sparing approach. This article explores current evidence for the effectiveness of kinesiotaping for the reduction of oedema in the postoperative setting.
A systematic literature search was performed on the basis of five databases (Pubmed, CINAHL, Embase, Cochrane Library, and Clinicaltrials.gov) for studies published between January 2000 and October 2019.Only prospective controlled trials were included. Case studies, uncontrolled case series, studies on oedema caused by other etiologies than by surgery, as well as studies on malignant disease related oedema (especially breast cancer related oedema) were excluded.Articles were screened by title, abstract, and full text and the references were searched for further publications on the topic. A narrative and quantitative (using STATA) analysis was performed.
One thousand two hundred sixty-three articles were screened, twelve were included in the analysis. All studies evaluated either oedema after extremity surgery or maxillofacial interventions, and showed relevant methodological flaws. Only three studies employed an active comparator. Of the twelve included studies ten found positive evidence for kinesiotape application for the reduction of swelling and beneficial effects on secondary outcome parameters such as pain and patient satisfaction. The available trials were heterogenic in pathology and all were compromised by a high risk of bias.
There is some evidence for the efficacy of kinesiotaping for the treatment of postoperative oedema. This evidence is, however, not yet convincing given the limitations of the published trials. Methodologically sound comparison to standard of care or an active comparator is indispensable for an evaluation of effectiveness. In addition, assessments of patient comfort and cost-benefit analyses are necessary to evaluate the potential relevance of this novel technique in daily practice.
International prospective register of systematic reviews (PROSPERO) ID 114129).
术后水肿是一种影响伤口愈合和功能的常见病症。传统上,采用手动淋巴引流来减轻肿胀。肌内效贴布可能是一种节省资源的替代方法。本文探讨了肌内效贴布在术后减轻水肿有效性方面的现有证据。
基于五个数据库(PubMed、CINAHL、Embase、Cochrane图书馆和Clinicaltrials.gov)对2000年1月至2019年10月发表的研究进行系统文献检索。仅纳入前瞻性对照试验。排除病例研究、非对照病例系列、关于手术以外其他病因引起的水肿的研究,以及关于恶性疾病相关水肿(尤其是乳腺癌相关水肿)的研究。通过标题、摘要和全文对文章进行筛选,并检索参考文献以获取该主题的更多出版物。进行了叙述性和定量(使用STATA)分析。
共筛选了1263篇文章,12篇纳入分析。所有研究均评估了肢体手术后或颌面干预后的水肿,并显示出相关的方法学缺陷。只有三项研究采用了活性对照。在纳入的12项研究中,有10项发现了肌内效贴布应用于减轻肿胀的阳性证据,以及对疼痛和患者满意度等次要结局参数的有益影响。现有试验在病理学方面存在异质性,且均存在高偏倚风险。
有一些证据表明肌内效贴布治疗术后水肿有效。然而,鉴于已发表试验的局限性,这一证据尚不令人信服。与护理标准或活性对照进行方法学上合理的比较对于评估有效性必不可少。此外,评估患者舒适度和成本效益分析对于评估这项新技术在日常实践中的潜在相关性是必要的。
国际系统评价前瞻性注册库(PROSPERO)ID 114129)