Dr. Marek Szczyt's Plastic Surgery Clinic, Warsaw, Poland.
Department of Anatomy, Jagiellonian University Medical College, 12th Kopernika Street, 31-034, Cracow, Poland.
Aesthetic Plast Surg. 2024 Jun;48(12):2224-2230. doi: 10.1007/s00266-024-03908-3. Epub 2024 Mar 8.
The following questions guided the study: Can the use of fibrin glue in drainless rhytidoplasty reduce hematoma prevalence, seroma prevalence increase patient satisfaction or decrease the length of hospital in the adult population compared with standard treatment? The following inclusion and exclusion criteria apply: The procedure performed was rhytidoplasty for both groups. Participants were limited to adults who did not have any other procedure performed during the study. The intervention consisted of the use of fibrin glue without drains compared to the control group, in which drains and/or pressure dressing were applied. Databases: clinicaltrials.gov, MEDLINE, COCHRANE, mRCT, PubMed, Google Scholar, Scopus, Embase, VHL, GHL were searched on 03/25/2023 by 2 different investigators. The Cochrane Risk of Bias Tool 2.0 was used. Five studies were included with a total number of 1277 participants (2554 face sides). The cumulative hematoma rate was OR 0.47 (95% CI 0.26-0.84) in favor of using fibrin glue. Insufficient data were available to assess seroma rate, patient satisfaction, and length of hospital stay. The risk of study bias was judged to be low and moderate. The certainty for the use of fibrin sealant versus drainage is high and the importance of outcomes is rated as important in the GRADEpro GDT tool. Fibrin glue use is more beneficial comparing to drainage in patients undergoing rhytidectomy in terms of hematoma prevalence. This study was registered in PROSPERO (CRD42023421475).Level of Evidence I This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
与标准治疗相比，在成年人中，使用纤维蛋白胶进行无引流除皱术是否可以降低血肿发生率、血清肿发生率、增加患者满意度或缩短住院时间？以下是纳入和排除标准：两组均行除皱术。参与者仅限于在研究期间未进行任何其他手术的成年人。干预措施包括使用纤维蛋白胶而不使用引流管，与对照组相比，对照组应用引流管和/或加压敷料。数据库：2023 年 3 月 25 日，由 2 名不同调查员在 clinicaltrials.gov、MEDLINE、COCHRANE、mRCT、PubMed、Google Scholar、Scopus、Embase、VHL、GHL 上进行了检索。使用 Cochrane 偏倚风险工具 2.0 进行评估。共纳入 5 项研究，共 1277 名参与者（2554 侧面部）。使用纤维蛋白胶的累积血肿发生率为 OR 0.47（95%CI 0.26-0.84）。尚无足够数据评估血清肿发生率、患者满意度和住院时间。研究偏倚风险判断为低中度。使用纤维蛋白密封剂与引流相比，其获益的确定性很高，在 GRADEpro GDT 工具中，结局的重要性被评为重要。在接受除皱术的患者中，与引流相比，使用纤维蛋白胶更有利于降低血肿发生率。本研究已在 PROSPERO（CRD42023421475）注册。证据水平 I 本杂志要求作者为每篇文章分配一个证据水平。有关这些循证医学评级的完整描述，请参阅目录或在线作者指南 www.springer.com/00266 。
