Khan Abbas Ali, Wood Benjamin, Abdul Zabihullah, Rahman Shafiq, Allouni Ammar
Cardiology, Royal Preston Hospital, Preston, GBR.
Plastic Surgery, Sheffield Teaching Hospitals NHS Foundation Trust, Northern General Hospital, Sheffield, GBR.
Cureus. 2021 Oct 20;13(10):e18924. doi: 10.7759/cureus.18924. eCollection 2021 Oct.
The use of abdominal drains in donor site closure following breast reconstruction with abdominal flaps is widespread. Our review aimed to compare the outcomes of donor site closure with and without the use of abdominal drains following breast reconstruction with abdominal flaps. Randomized, non-randomized, and observational studies that compared the use of drains vs. no drain in breast reconstruction were included by searching MEDLINE, EMBASE, EMCARE, CINAHL, and the Cochrane Central Register of Controlled Trials (CENTRAL). Four studies enrolling 327 participants were identified. A statistically significant difference was found in terms of duration of hospital stay favouring abdominal closure without the use of drains (MD = -1.15, 95% CI = -1.88 tom-0.42, P=0.002), with a similar difference found in terms of overall complication rate (OR = 0.44, 95% CI = 0.23 to 0.83, p=0.01). Likewise, a statistically significant difference was found favouring abdominal closure without the use of drains for the secondary outcome of operative time (MD = -55.95, 95% CI = -107.19 to -4.74, p=0.03). Abdominal closure without drains following breast reconstructions with abdominal flaps is superior to closure with drains.
在采用腹部皮瓣进行乳房重建后，供区关闭时使用腹腔引流管的情况很普遍。我们的综述旨在比较采用腹部皮瓣进行乳房重建后，使用和不使用腹腔引流管进行供区关闭的效果。通过检索MEDLINE、EMBASE、EMCARE、CINAHL以及Cochrane对照试验中央注册库（CENTRAL），纳入了比较乳房重建中使用引流管与不使用引流管的随机、非随机和观察性研究。共确定了四项研究，涉及327名参与者。结果发现，在住院时间方面存在统计学显著差异，倾向于不使用引流管的腹部关闭方式（MD = -1.15，95% CI = -1.88至-0.42，P = 0.002），在总体并发症发生率方面也发现了类似差异（OR = 0.44，95% CI = 0.23至0.83，p = 0.01）。同样，在手术时间这一次要结局方面，也发现了统计学显著差异，倾向于不使用引流管的腹部关闭方式（MD = -55.95，95% CI = -107.19至-4.74，p = 0.03）。采用腹部皮瓣进行乳房重建后，不使用引流管的腹部关闭方式优于使用引流管的关闭方式。
