Department of Orthopaedics, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.
Clinical Epidemiology and Clinical Statistic Center, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.
Int Orthop. 2022 Aug;46(8):1-8. doi: 10.1007/s00264-022-05440-y. Epub 2022 May 19.
To investigate the association between diabetes mellitus and risk of infection after trigger finger release.
Reports of adult trigger finger patients who had undergone trigger finger release that included details of patient diabetic status and post-surgery infections were included in the study. Reports of congenital trigger finger release and incomplete data on either diabetic status or infection after surgery were excluded. Search engines were PubMed, Scopus, the Cochrane Central Register of Controlled Trials, and Web of Science from inception to third December 2021. The risk of infection after trigger finger release was compared between diabetic and non-diabetic patients by evaluating the pooled risk ratio (RR) with a 95% confident interval (CI) under random effects modeling. Risk of bias in each study was assessed using Newcastle-Ottawa Scale (NOS).
A total of 213,071 trigger finger patients described in seven studies were identified. Overall, patients with diabetes mellitus had a 65% higher risk of infection after trigger finger release compared to non-diabetic patients (RR 1.65; 95% CI, 1.39-1.95). Diabetes mellitus increased the risk of infection following trigger finger surgery in both young and old age groups as well as obese and non-obese patients who underwent open release surgery. The risk of bias in each of the included studies was estimated as moderate to high.
Meta-analysis results demonstrated that diabetes mellitus increases the risk of infection after trigger finger release. Glycemic control and percutaneous rather than open surgery might be strategies to the reduce risk of infection after trigger finger release in diabetic patients.
探讨糖尿病与扳机指松解术后感染风险的关系。
纳入研究的报告包括接受过扳机指松解术的成年扳机指患者，报告中详细说明了患者的糖尿病状况和术后感染情况。排除先天性扳机指松解术和糖尿病状态或术后感染数据不完整的报告。检索了从建立到 2021 年 12 月 3 日的 PubMed、Scopus、Cochrane 中央对照试验注册库和 Web of Science 等搜索引擎。采用随机效应模型评估汇总风险比（RR），比较糖尿病和非糖尿病患者术后扳机指松解后的感染风险。采用 Newcastle-Ottawa 量表（NOS）评估每个研究的偏倚风险。
共纳入了 7 项研究的 213071 例扳机指患者。总体而言，与非糖尿病患者相比，糖尿病患者术后感染的风险增加了 65%（RR 1.65；95% CI，1.39-1.95）。糖尿病患者在年轻和老年人群以及接受开放松解术的肥胖和非肥胖患者中，术后扳机指手术后感染的风险均增加。纳入的研究中每个研究的偏倚风险估计为中度至高度。
荟萃分析结果表明，糖尿病增加了扳机指松解术后感染的风险。控制血糖和采用经皮而非开放性手术可能是降低糖尿病患者术后扳机指松解术感染风险的策略。
