From the Department of Medicine, University of Saskatchewan, Saskatoon, Sask. (Kim); the Department of Surgery, University of Alberta Hospital, University of Alberta, Edmonton, Alta. (Verhoeff, Jogiat, Miles, Mocanu); the John W. Scott Health Sciences Library, University of Alberta, Edmonton, Alta. (Kung).
From the Department of Medicine, University of Saskatchewan, Saskatoon, Sask. (Kim); the Department of Surgery, University of Alberta Hospital, University of Alberta, Edmonton, Alta. (Verhoeff, Jogiat, Miles, Mocanu); the John W. Scott Health Sciences Library, University of Alberta, Edmonton, Alta. (Kung)
Can J Surg. 2024 Sep 27;67(5):E329-E336. doi: 10.1503/cjs.008423. Print 2024 Sep-Oct.
Prolonged packing of anorectal abscess cavities with internal dressings after incision and drainage is frequently used, but the efficacy of this practice remains controversial. Some studies highlight its use in hemostasis and preventing fistula and abscess recurrence, whereas others describe its economic burden and increase in pain. In this systematic review, we examine current evidence on the impact of packing after incision and drainage for anorectal abscesses.
The medical librarian conducted a comprehensive literature search on January 5, 2023. We conducted the meta-analysis using RevMan 5.4.1 software with a Mantel-Haenszel random-effects model.
We identified 3 randomized controlled trials, comprising 490 patients. Of those, 241 patients (49%) received postoperative packing; most patients were male ( = 158, 65.6%), with a median age of 40.5 years and a follow-up of 6 months. Meta-analysis showed that prolonged wound packing was associated with delayed wound healing and increased pain, but no difference in abscess recurrence or fistula formation.
In this systematic review of current evidence highlighting the impact of packing after incision and drainage for anorectal abscesses, we found that the practice is not associated with significant differences in abscess recurrence and fistula formation, but is associated with increased postoperative pain and delayed wound healing.
切开引流后用内置敷料长时间填塞肛门直肠脓肿腔经常被使用，但这种做法的疗效仍存在争议。一些研究强调其在止血和预防瘘管和脓肿复发方面的作用，而另一些研究则描述了其经济负担和增加的疼痛。在本次系统评价中，我们研究了切开引流后填塞对肛门直肠脓肿的影响的现有证据。
医学图书管理员于 2023 年 1 月 5 日进行了全面的文献检索。我们使用 RevMan 5.4.1 软件进行荟萃分析，采用 Mantel-Haenszel 随机效应模型。
我们确定了 3 项随机对照试验，共纳入 490 名患者。其中 241 名患者（49%）接受了术后填塞；大多数患者为男性（=158，65.6%），中位年龄为 40.5 岁，随访时间为 6 个月。荟萃分析表明，长时间的伤口填塞与伤口愈合延迟和疼痛增加有关，但脓肿复发或瘘管形成无差异。
在本次对切开引流后填塞肛门直肠脓肿影响的现有证据的系统评价中，我们发现该方法与脓肿复发和瘘管形成无显著差异相关，但与术后疼痛增加和伤口愈合延迟相关。
