Nguyen Marie, Foreman Andrew, Lockwood Craig
JBI, School of Public Health, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, SA, Australia.
Adelaide Medical School, The University of Adelaide, Adelaide, SA, Australia.
JBI Evid Synth. 2024 Jun 1;22(6):1151-1160. doi: 10.11124/JBIES-23-00142.
This review will investigate the effectiveness of fibrin sealants in adult patients who underwent head and neck surgery.
Controlling bleeding is important in head and neck surgery. Complications involving nearby vital structures increase the risk of morbidity and mortality. Surgical tissue adhesives are used in addition to other traditional hemostatic methods to reduce surgical site bleeding. Fibrin sealants have shown some success compared with other tissue adhesives, but individual studies have been inconclusive.
We will include studies comparing fibrin sealants with placebo or usual care in patients 18 years or older who have undergone soft tissue surgery of the head and neck with drain placement. Primary outcomes include wound complications and time to surgical drain removal. Secondary outcomes include length of hospital stay, drain volume output, surgical management of postoperative hematoma, rate of blood transfusions, and adverse reactions.
We will search electronic databases (PubMed, Embase, Cochrane Central Register of Controlled Trials CINAHL, Scopus, Web of Science) for studies published from 1975 onwards. Sources to be search for unpublished literature will include ClinicalTrials.gov, WHO International Clinical Trials Registry Platform, MedNar, and ProQuest Dissertations and Theses. Titles, abstracts, and full-text papers will be assessed against the inclusion criteria by 2 independent reviewers. Study screening and selection will be performed, and critical appraisal conducted using the standardized JBI appraisal tools. Data will be extracted by 2 independent reviewers. Meta-analysis will be conducted for all outcomes where appropriate, with weighted mean differences for continuous data. Risk ratios will be used for dichotomous data. Certainty will be reported using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach.
PROSPERO CRD42023412820.
本综述将调查纤维蛋白密封剂在接受头颈外科手术的成年患者中的有效性。
控制出血在头颈外科手术中很重要。涉及附近重要结构的并发症会增加发病和死亡风险。除其他传统止血方法外，还使用手术组织粘合剂来减少手术部位出血。与其他组织粘合剂相比，纤维蛋白密封剂已显示出一定的成功，但个别研究尚无定论。
我们将纳入比较纤维蛋白密封剂与安慰剂或常规护理的研究，研究对象为18岁及以上接受头颈软组织手术并放置引流管的患者。主要结局包括伤口并发症和手术引流管拔除时间。次要结局包括住院时间、引流量、术后血肿的手术处理、输血率和不良反应。
我们将检索电子数据库（PubMed、Embase、Cochrane对照试验中央注册库、CINAHL、Scopus、科学网），查找1975年起发表的研究。查找未发表文献的来源将包括ClinicalTrials.gov、世界卫生组织国际临床试验注册平台、MedNar以及ProQuest学位论文数据库。标题、摘要和全文论文将由2名独立评审员根据纳入标准进行评估。将进行研究筛选和选择，并使用标准化的JBI评估工具进行批判性评价。数据将由2名独立评审员提取。将对所有合适的结局进行荟萃分析，连续数据采用加权平均差。二分数据将使用风险比。将使用推荐分级、评估、制定和评价（GRADE）方法报告确定性。
PROSPERO CRD42023412820。
