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负压伤口引流与甲状腺肿瘤手术后自然伤口引流的影响比较:一项荟萃分析。

Impact of negative pressure wound drainage compared with natural wound drainage after thyroid tumour surgery: A meta-analysis.

机构信息

Department of Pharmacy Practice, College of Pharmacy, Shaqra University, Shaqra, Saudi Arabia.

Department of Clinical Pharmacy, National Cancer Institute, Cairo University, Giza, Egypt.

出版信息

Int Wound J. 2023 Apr;20(4):1183-1190. doi: 10.1111/iwj.13977. Epub 2022 Oct 17.

Abstract

We conducted a meta-analysis to compare the effectiveness of negative pressure wound drainage to that of spontaneous wound drainage after thyroid tumour surgery. A thorough analysis of the literature up to July 2022 revealed that, of the 1234 patients who used surgery for thyroid tumours, 615 used negative pressure wound drainage and 619 used natural wound drainage. To measure the influence of negative pressure wound drainage in comparison to natural wound drainage following thyroid tumour surgery, mean difference (MD) and odds ratio (OR) with 95% confidence intervals (CIs) were measured using the contentious and dichotomous approaches with a random or fixed-effect model. Subjects who used negative pressure wound drainage had significantly higher averages for drained material (OR, 12.52; 95% CI, 6.78-18.26, P = 0.001), shorter drain placement times (MD, -1.06; 95% CI, 1.57 to -0.55, P = .001), lower rates of infection at the surgical site (OR, 0.17; 95% CI, 0.05-0.60, P = .006), higher rates of wound healing (OR, 5.91; 95% CI, 1.56-22.34, P = .009), and lower rate of wound seroma (OR, 0.21; 95% CI, 0.10-0.42, P < .001) in subjects after thyroid tumour surgery in comparison to subjects who used natural wound drainage after thyroid tumour surgery. Those who used negative pressure wound drainage had significantly higher averages of drained material, shorter drain placement times, lower rates of wound infection at the surgical site, higher rates of wound healing, and lower rates of wound seroma. Care must be used when analysing the results because of the small sample size of 7 of the 13 studies included in the meta-analysis and the lack of studies in several comparisons.

摘要

我们进行了一项荟萃分析,比较了甲状腺肿瘤手术后负压伤口引流与自发性伤口引流的效果。对截至 2022 年 7 月的文献进行全面分析后发现,在 1234 名接受甲状腺肿瘤手术的患者中,615 名使用了负压伤口引流,619 名使用了自然伤口引流。为了衡量与甲状腺肿瘤手术后自然伤口引流相比,负压伤口引流的影响,我们使用有争议和二分法,采用随机或固定效应模型,以均数差(MD)和比值比(OR)及其 95%置信区间(CI)进行测量。与使用自然伤口引流的患者相比,使用负压伤口引流的患者引流物的平均量更高(OR,12.52;95%CI,6.78-18.26,P=0.001),引流管放置时间更短(MD,-1.06;95%CI,1.57 至-0.55,P=0.001),手术部位感染率更低(OR,0.17;95%CI,0.05-0.60,P=0.006),伤口愈合率更高(OR,5.91;95%CI,1.56-22.34,P=0.009),伤口血清肿发生率更低(OR,0.21;95%CI,0.10-0.42,P<0.001)。与使用甲状腺肿瘤手术后自然伤口引流的患者相比,甲状腺肿瘤手术后使用负压伤口引流的患者引流物的平均量更高,引流管放置时间更短,手术部位感染率更低,伤口愈合率更高,伤口血清肿发生率更低。由于荟萃分析中纳入的 13 项研究中有 7 项的样本量较小,且在几个比较中缺乏研究,因此在分析结果时必须谨慎。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/282f/10031204/ed1b5aef3070/IWJ-20-1183-g003.jpg

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