Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China.
Department of Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China.
Surg Infect (Larchmt). 2021 Nov;22(9):877-883. doi: 10.1089/sur.2021.009. Epub 2021 May 14.
Wound complications, primarily surgical site infections (SSIs), impose heavy a heavy burden on public health. This study aimed to compare the difference in the abilities of subcuticular sutures and staples to prevent SSIs after open abdominal surgery on the digestive system. A comprehensive search in Ovid-MEDLINE, Embase, Web of Science, and Cochrane Library (Central Register of Controlled Trials) was performed in January 2021. This study was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The PICOS (population, intervention, control, outcome, study type) model was applied to guide study selection and data extraction. Six studies including 3,863 participants were included. According to analysis of SSI incidence, there was no obvious difference between the incidence of SSI when subcuticular sutures and staples were used (odds ratio [OR], 0.81; 95% confidence interval [CI], 0.61-1.08; p = 0.15). In the subsequent subgroup analysis of different operation procedures, the pooled results also failed to show significance for upper gastrointestinal surgery (OR, 1.09; 95% CI, 0.63-1.9; p = 0.75), lower gastrointestinal surgery (OR, 0.77; 95% CI, 0.56-1.05; p = 0.1), or hepatobiliary-pancreatic surgery (pooled OR, 0.72; 95% CI, 0.34-1.54; p = 0.4). Subcuticular sutures and staples did not show differences in their ability to prevent SSI incidence after open abdominal operation. These results require further verification by large-scale, high-quality randomized controlled trials.
切口并发症，主要是手术部位感染（SSI），给公共卫生带来了沉重负担。本研究旨在比较皮下缝合与皮钉在预防消化系统开放性腹部手术后 SSI 方面的差异。2021 年 1 月，我们在 Ovid-MEDLINE、Embase、Web of Science 和 Cochrane Library（中央对照试验注册库）进行了全面检索。本研究按照系统评价和荟萃分析的 Preferred Reporting Items（PRISMA）指南进行。应用 PICOS（人群、干预、对照、结局、研究类型）模型来指导研究选择和数据提取。纳入了 6 项研究，共 3863 名参与者。根据 SSI 发生率分析，皮下缝合与皮钉使用时 SSI 发生率无明显差异（比值比 [OR]，0.81；95%置信区间 [CI]，0.61-1.08；p=0.15）。在不同手术程序的亚组分析中，汇总结果也未能显示在上消化道手术（OR，1.09；95% CI，0.63-1.9；p=0.75）、下消化道手术（OR，0.77；95% CI，0.56-1.05；p=0.1）或肝胆胰手术（汇总 OR，0.72；95% CI，0.34-1.54；p=0.4）中具有统计学意义。皮下缝合与皮钉在预防开放性腹部手术后 SSI 发生率方面无差异。这些结果需要进一步通过大规模、高质量的随机对照试验来验证。
