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外科缝合后湿性敷料在伤口愈合中的效果:一项随机对照试验的贝叶斯网状Meta 分析。

Effectiveness of moist dressings in wound healing after surgical suturing: A Bayesian network meta-analysis of randomised controlled trials.

机构信息

Department of Neurosurgery, West China Hospital, Sichuan University, Chengdu, China.

出版信息

Int Wound J. 2023 Jan;20(1):69-78. doi: 10.1111/iwj.13839. Epub 2022 May 12.

Abstract

The moist healing theory proves that a moderately moist and airtight environment is conducive to wound healing. However, different moist dressings have different functions. We aim to evaluate the effects of moist dressings on wound healing after surgical suturing and identify superior moist dressings. Randomised controlled trials investigating the application of moist dressings were retrieved from electronic databases, including PubMed, EMBASE, Web of Science, and the Cochrane Library. Wound healing, surgical site infection (SSI), and times of dressing change were assessed. The values of the surface under the cumulative ranking (SUCRA) curve were calculated based on the Bayesian network meta-analysis. Inconsistency tests and funnel plots were applied to analyse the consistency and publication bias. All the analysis complies with the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) 2020 Checklist and AMSTAR (Assessing the Methodological Quality of Systematic Reviews) Guidelines. Sixteen randomised controlled trials involving 4444 patients were pooled in the network meta-analysis. The ionic silver dressing (SUCRA, 93%) ranked first in wound healing, the metallic silver dressing (SUCRA, 75.9%) ranked first in SSI, and the hydrocolloid dressing (SUCRA, 73.9%) ranked first in times of dressing change. Inconsistency was only observed in wound healing, and no publication bias was observed in this study. The effects of moist dressings are better than gauze dressings in the process of wound healing. The ionic silver dressing is effective in wound healing, whereas the metallic silver dressing is effective in SSI prevention. The hydrocolloid dressing requires the fewest times of dressing change. More high-quality RCTs are required to support the network meta-analysis.

摘要

湿润愈合理论证明,适度湿润且密闭的环境有利于伤口愈合。然而,不同的湿性敷料具有不同的功能。我们旨在评估手术后缝合时使用湿性敷料对伤口愈合的影响,并确定更优的湿性敷料。从电子数据库(PubMed、EMBASE、Web of Science 和 Cochrane Library)中检索了关于湿性敷料应用的随机对照试验。评估了伤口愈合、手术部位感染(SSI)和更换敷料的次数。基于贝叶斯网状meta 分析计算了累积排序概率曲线(SUCRA)下的数值。应用一致性检验和漏斗图分析一致性和发表偏倚。所有分析均符合 PRISMA(系统评价和荟萃分析的首选报告项目)2020 清单和 AMSTAR(系统评价方法学质量评估)指南。纳入的 16 项随机对照试验共纳入 4444 例患者,进行了网状meta 分析。离子银敷料(SUCRA,93%)在伤口愈合方面排名第一,金属银敷料(SUCRA,75.9%)在 SSI 方面排名第一,水胶体敷料(SUCRA,73.9%)在更换敷料次数方面排名第一。仅在伤口愈合方面观察到不一致性,本研究未观察到发表偏倚。湿性敷料在伤口愈合过程中的效果优于纱布敷料。离子银敷料在伤口愈合方面有效,而金属银敷料在预防 SSI 方面有效。水胶体敷料需要更换敷料的次数最少。需要更多高质量的 RCT 来支持网状meta 分析。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7869/9797923/6cb6dd577c91/IWJ-20-69-g002.jpg

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