Merdad Mazin, Alqutub Abdulsalam, Magboul Maan, Awadh Mohammed, Faidah Hassan, Aljohani Abdulaziz G, Fadel Hamza A, Abumohssin Abdulelah G, Mogharbel Ahmed
Department of Otorhinolaryngology-Head and Neck Surgery, King Abdulaziz University, Jeddah, Saudi Arabia.
Department of Otorhinolaryngology-Head and Neck Surgery, Makkah Health Cluster, Makkah, Saudi Arabia.
Aesthetic Plast Surg. 2025 Aug 7. doi: 10.1007/s00266-025-05083-5.
Thyroidectomy is among the most common surgical procedures worldwide. Despite advancements in surgical techniques, cosmetic outcomes following thyroidectomy continue to be a major concern. One of the key factors that could influence postoperative results is the method of wound closure; however, there is no established consensus on the optimal wound closure approach. Our study aims to compare the cosmetic outcomes of the available wound closure methods in patients undergoing thyroidectomy.
We conducted an extensive search across four databases until February 2025. We included all studies that evaluate the cosmetic outcomes of various wound closure methods after thyroidectomy. Our primary outcomes were the Patient and Observer Scar Assessment Scales (POSAS), operative time required for wound closure, and the ability to shower. Continuous outcomes were analyzed as mean differences (MD) with their 95% confidence intervals (CI), while dichotomous variables were pooled as risk ratios (RR) with 95% CI.
Our review included twelve randomized controlled trials and three observational cohort studies involving 1131 patients who underwent thyroidectomy. The pooled analysis revealed higher OSAS in the tissue adhesive group compared to the subcuticular suture group (MD=4.50, 95% CI [1.83 to 7.16], p=0.001). However, there was no significant difference between the two approaches regarding PSAS scores (MD=4.16, 95% CI [ -4.18 to 12.51], p=0.33). Additionally, tissue adhesives were linked to a shorter wound closure time compared to subcuticular sutures (MD= -3.33, 95% CI [ -5.88 to -0.78], p=0.01). When compared to staples, tissue adhesives exhibited higher rates of excellent ability to shower (RR=5.66, 95% CI [1.87 to 17.13], p=0.001).
Tissue adhesive is associated with poorer scar appearance but faster wound closure when compared to subcuticular sutures. Moreover, tissue adhesive also showed a better ability to shower compared to staples.
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甲状腺切除术是全球最常见的外科手术之一。尽管手术技术有所进步，但甲状腺切除术后的美容效果仍是一个主要问题。影响术后结果的关键因素之一是伤口闭合方法；然而，对于最佳的伤口闭合方法尚未达成共识。我们的研究旨在比较甲状腺切除患者中现有伤口闭合方法的美容效果。
我们在四个数据库中进行了广泛检索，直至2025年2月。我们纳入了所有评估甲状腺切除术后各种伤口闭合方法美容效果的研究。我们的主要结局是患者和观察者瘢痕评估量表（POSAS）、伤口闭合所需的手术时间以及淋浴能力。连续结局以均值差（MD）及其95%置信区间（CI）进行分析，而二分变量则合并为风险比（RR）及其95%CI。
我们的综述纳入了12项随机对照试验和3项观察性队列研究，涉及1131例接受甲状腺切除术的患者。汇总分析显示，与皮下缝合组相比，组织粘合剂组的OSAS更高（MD = 4.50，95%CI [1.83至7.16]，p = 0.001）。然而，在PSAS评分方面，两种方法之间没有显著差异（MD = 4.16，95%CI [-4.18至12.51]，p = 0.33）。此外，与皮下缝合相比，组织粘合剂与更短的伤口闭合时间相关（MD = -3.33，95%CI [-5.88至-0.78]，p = 0.01）。与吻合钉相比，组织粘合剂在淋浴能力方面表现出更高的优秀率（RR = 5.66，95%CI [1.87至17.13]，p = 0.001）。
与皮下缝合相比，组织粘合剂与较差的瘢痕外观相关，但伤口闭合更快。此外，与吻合钉相比，组织粘合剂在淋浴能力方面也表现更好。
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