Department of Otolaryngology-Head and Neck Surgery, Louisiana State University Health Sciences Center, Shreveport, Louisiana, USA.
Department of Otolaryngology-Head and Neck Surgery, McGill University Health Center, Montreal, Canada.
Otolaryngol Head Neck Surg. 2021 Jun;164(6):1148-1152. doi: 10.1177/0194599820964727. Epub 2020 Oct 13.
To systematically review the literature to determine the difference in complications between standard twill and Velcro ties following pediatric tracheostomy.
MEDLINE, Embase, the Cochrane Database of Systematic Reviews, the Cochrane Central Register of Controlled Trials, Web of Science, and CINAHL Plus were searched up to August 2020.
Two authors independently screened articles for eligibility. Retrospective and prospective studies were included as long as there was a direct comparison between twill and Velcro ties. Quantitative and qualitative analysis was performed. The main outcomes were skin-related complications and accidental decannulation.
Three studies were included in the final analysis: 1 randomized prospective trial and 2 retrospective studies. There were 238 patients total (137 twill, 101 Velcro). Combined analysis showed skin-related complications in 23% of the Velcro group and 44% of the twill group. Meta-analysis for skin-related complications showed no significant difference when comparing Velcro with standard twill ties (risk ratio, 0.53 [95% CI, 0.24-1.17]; = .12, n = 238 participants from 3 studies, = 66%). Accidental decannulation rates were overall low and comparable between groups (1.0% of twill, 1.4% of Velcro).
Based on limited data, skin-related complications were not statistically different between Velcro and twill ties. Accidental decannulation is rare with Velcro and standard twill ties, and both are viable options following pediatric tracheostomy.
系统回顾文献，以确定儿童气管切开术后标准斜纹和魔术贴系带之间并发症的差异。
截至 2020 年 8 月，检索 MEDLINE、Embase、Cochrane 系统评价数据库、Cochrane 对照试验中心注册库、Web of Science 和 CINAHL Plus。
两名作者独立筛选文章的资格。只要有斜纹和魔术贴之间的直接比较，回顾性和前瞻性研究都被包括在内。进行了定量和定性分析。主要结果是皮肤相关并发症和意外拔管。
最终分析纳入了 3 项研究：1 项随机前瞻性试验和 2 项回顾性研究。总共有 238 名患者（137 名斜纹，101 名魔术贴）。综合分析显示，魔术贴组中有 23%的患者出现皮肤相关并发症，斜纹组中有 44%的患者出现皮肤相关并发症。比较魔术贴与标准斜纹系带的皮肤相关并发症的荟萃分析显示，两者之间无显著差异（风险比，0.53 [95%CI，0.24-1.17]； =.12，n = 3 项研究中的 238 名参与者， = 66%）。意外拔管的发生率总体较低，且两组之间无差异（斜纹组 1.0%，魔术贴组 1.4%）。
基于有限的数据，魔术贴和斜纹系带之间的皮肤相关并发症无统计学差异。意外拔管在使用魔术贴和标准斜纹系带时均很少见，两者都是儿童气管切开术后可行的选择。
