Jacobs Tyler, Patil Disha, Ziccardi Vincent B
Resident, Department of Oral and Maxillofacial Surgery, Rutgers School of Dental Medicine, Newark, NJ.
M.D. Candidate, Rutgers New Jersey Medical School, Newark, NJ.
J Oral Maxillofac Surg. 2024 Dec;82(12):1559-1568. doi: 10.1016/j.joms.2024.08.010. Epub 2024 Aug 13.
The study purpose was to measure and compare the time to functional sensory recovery (FSR) and incidence of FSR by 6 and 12 months between type I bovine collagen conduits versus porcine small intestine submucosa (SIS) conduits with primary neurorrhaphy for peripheral nerve injury repair.
A systematic review and meta-analysis following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were conducted. The predictor variable was the type of conduit-either bovine collagen or porcine SIS. The primary outcome variable was the number of months between surgery and the patient achieving FSR. The secondary outcome variable was the proportion of patients who achieved FSR that did so by 6 and 12 months. A log-rank test was performed to evaluate the statistical significance of the differences observed in the overall time-to-FSR data and by 6 and 12 months.
We screened 67 publications of which 8 were included. The sample sizes were 137 and 96 patients for the bovine collagen and porcine SIS groups, respectively. The median time to FSR for the bovine collagen conduit group was 9 months (interquartile range: 6); the median time to FSR for the porcine SIS conduit group 6 months (interquartile range: 3 months) (P = .50). Of the patients who achieved FSR, 42% of patients with bovine collagen conduits and 64% of patients with porcine SIS conduits did so within 6 months (P < .01). Of the patients who achieved FSR, 94% of patients with bovine collagen conduits and 82% of patients with porcine SIS conduits did so within 12 months (P < .01).
Although a significant difference was found in the incidence of FSR at 6 and 12 months, no significant difference was found in overall time to FSR, supporting the use of either conduit for peripheral nerve repair.
本研究旨在测量并比较Ⅰ型牛胶原蛋白导管与猪小肠黏膜下层（SIS）导管在一期神经缝合修复周围神经损伤时，达到功能性感觉恢复（FSR）的时间以及6个月和12个月时FSR的发生率。
按照系统评价和Meta分析的首选报告项目（PRISMA）指南进行系统评价和Meta分析。预测变量为导管类型——牛胶原蛋白或猪SIS。主要结局变量为手术至患者实现FSR的月数。次要结局变量为在6个月和12个月时实现FSR的患者比例。进行对数秩检验以评估在FSR总时间数据以及6个月和12个月时观察到的差异的统计学显著性。
我们筛选了67篇文献，其中8篇被纳入。牛胶原蛋白组和猪SIS组的样本量分别为137例和96例患者。牛胶原蛋白导管组达到FSR的中位时间为9个月（四分位间距：6）；猪SIS导管组达到FSR的中位时间为6个月（四分位间距：3个月）（P = 0.50）。在实现FSR的患者中，使用牛胶原蛋白导管的患者有42%在6个月内实现，使用猪SIS导管的患者有64%在6个月内实现（P < 0.01）。在实现FSR的患者中，使用牛胶原蛋白导管的患者有94%在12个月内实现，使用猪SIS导管的患者有82%在12个月内实现（P < 0.01）。
尽管在6个月和12个月时FSR的发生率存在显著差异，但在达到FSR的总时间上未发现显著差异，这支持两种导管均可用于周围神经修复。
