Tang Xiongfei, Shi Wenfeng, Qian Yuening, Ge Zhen
Department of Orthopaedics, Haining People's Hospital, Haining, China.
Int Wound J. 2024 Jan;21(1):e14372. doi: 10.1111/iwj.14372. Epub 2023 Sep 7.
The purpose of this meta-analysis is to determine if the application of stitching in the closed area of the knee arthroplasty remains significantly superior to that of the staples. Data sources: EMBASE, Cochrane Libraryand, publications, and the Web of Science. Patients were treated with staples for closure of their wounds, or with conventional stitches for closure of wounds. The main findings were surgical site infection, wound dehiscence, and cutting time. The secondary results were the time to completion, the duration of the hospitalization, and the time to discharge. We incorporated the SIX trial into the meta-analyses with Review Manager V.5.3. The hazard ratio was computed as a therapeutic outcome with respect to the heterogeneity. For more than 50% of heterogeneous samples, we employed a stochastic effect model. The results showed that there was no significant difference in the degree of infection, the degree of dehiscence, the length of the cut and the degree of satisfaction of the wound. But the time to close the wound and the time to operate were significantly different. The time needed to close the wound was shorter than that of the suture (OR, -227. 22; 95% CI, -238. 74, -215. 69 p < 0. 0001); The time taken to replace the knee was also significantly lower among those who had been stapled sutures (OR, -5.46; 95% CI, -10. 43, -0.49 p = 0. 03). Wound closing materials are an afterthought for many orthopaedic surgeons. Together, the findings from a number of comparative studies indicate that the selection of wound closure materials might affect the outcome of the surgery. The evidence, however, is weak because of the heterogeneous approach adopted in earlier research. This study program is intended to provide guidance on how to select the best wound closure material for the purpose of identifying if there is any difference in the incidence of injuries among traditional stitches and staples.
本荟萃分析的目的是确定在膝关节置换术的闭合区域应用缝合线是否仍显著优于吻合钉。数据来源：EMBASE、Cochrane图书馆、出版物以及科学网。患者伤口闭合采用吻合钉治疗或传统缝线治疗。主要观察指标为手术部位感染、伤口裂开和切割时间。次要结果为完成时间、住院时间和出院时间。我们使用Review Manager V.5.3将SIX试验纳入荟萃分析。计算风险比作为治疗效果，并分析异质性。对于超过50%的异质性样本，我们采用随机效应模型。结果显示，在感染程度、裂开程度、切口长度和伤口满意度方面无显著差异。但伤口闭合时间和手术时间有显著差异。伤口闭合所需时间比缝线短（OR，-227.22；95%CI，-238.74，-215.69；p＜0.0001）；在使用吻合钉缝线的患者中，膝关节置换所需时间也显著更短（OR，-5.46；95%CI，-10.43，-0.49；p = 0.03）。伤口闭合材料是许多骨科医生事后才考虑的事情。多项比较研究的结果共同表明，伤口闭合材料的选择可能会影响手术结果。然而，由于早期研究采用的方法存在异质性，证据并不充分。本研究计划旨在为如何选择最佳伤口闭合材料提供指导，以确定传统缝线和吻合钉在损伤发生率上是否存在差异。
