荷包缝合与线性缝合在肠造口还纳术后皮肤切口关闭中的应用：一项随机对照试验的荟萃分析及系统综述。
Purse-string versus linear closure of the skin wound following stoma reversal: A meta-analysis with RCT and systematic review.
机构信息
Department of Colorectal Anal Surgery, Zigong Fourth People's Hospital, Zigong, Sichuan Province, China.
Department of Gastrointestinal Oncology, The First Affiliated Hospital of Hainan Medical University, Haikou, Hainan Province, China.
出版信息
Medicine (Baltimore). 2024 Aug 30;103(35):e39477. doi: 10.1097/MD.0000000000039477.
BACKGROUND
Linear closure (LC) following stoma reversal is associated with a high risk of surgical site infection (SSI). Purse-string closure and LC were both positive for the closure of the skin wound following stoma reversal, and it was not yet possible to distinguish which one was more beneficial to the patient's prognosis.
METHODS
We conducted a search in Embase, PubMed, Web of Science, and Cochrane Library and conducted a randomized controlled experiment from the inception of each database to July 2024. Among them, the SSI within 30 days, operation time, hospitalization time, incisional hernia, and wound healing time were all outcome indicators.
RESULTS
Eleven studies were included in this meta-analysis (506 patients in the purse-string closure group and 489 patients in the LC group). The pooled data showed that the SSI rate was significantly lower in the purse-string closure group than in the LC group (odds ratio, 0.15; 95% confidence interval, 0.09-0.24; P < .00001; I2 = 0%). The differences in operative time, hospitalization time, incision hernia, and wound healing time were not statistically significant.
CONCLUSION
Overall, purse-string closure had a significantly lower SSI rate following stoma reversal than LC.
背景
肠造口还纳术后行线性缝合（LC）与较高的手术部位感染（SSI）风险相关。荷包缝合和 LC 均可用于肠造口还纳术后的皮肤切口缝合，尚无法确定哪种方法更有利于患者的预后。
方法
我们在 Embase、PubMed、Web of Science 和 Cochrane Library 进行了检索，并对每个数据库的创建时间至 2024 年 7 月进行了随机对照试验。其中，30 天内 SSI、手术时间、住院时间、切口疝和伤口愈合时间均为结局指标。
结果
本荟萃分析纳入了 11 项研究（荷包缝合组 506 例，LC 组 489 例）。汇总数据显示，荷包缝合组 SSI 发生率明显低于 LC 组（比值比，0.15；95%置信区间，0.09-0.24；P<0.00001；I²=0%）。手术时间、住院时间、切口疝和伤口愈合时间的差异无统计学意义。
结论
总体而言，肠造口还纳术后荷包缝合的 SSI 发生率明显低于 LC。
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