A systematic review of systematic reviews and panoramic meta-analysis: staples versus sutures for surgical procedures.
A systematic review of systematic reviews and panoramic meta-analysis: staples versus sutures for surgical procedures.
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DOI：
10.1371/journal.pone.0075132
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发表时间：
2013
期刊：
影响因子：
3.7
通讯作者：
Lilford RJ
中科院分区：
文献类型：
--
作者：
Hemming K;Pinkney T;Futaba K;Pennant M;Morton DG;Lilford RJ
旨在系统地评价外科专业中关于斯台普斯或缝线是否能更好地改善患者和提供者水平结局的证据。系统性综述的系统性综述和汇总估计值的全景荟萃分析。11篇系统性综述，包括13，661个观察结果，符合纳入标准。在骨科手术中，发现缝线是首选，对于阑尾残端，缝线可防止手术部位感染和术后并发症。然而，斯台普斯可防止回肠吻合术中的泄漏。对于所有其他手术类型，证据是不确定的，置信区间较宽，包括斯台普斯或缝线的手术部位感染或术后并发症的可能优先结局。虽然综述显示手术时间的平均差异有很大差异（I2 94%），但有明确证据表明所有手术类型的平均手术时间缩短。很少有综述报告了住院时间，但有3篇综述（I2 0%，包括950个观察结果）显示住院时间没有显著缩短，但显示了发表偏倚的证据（Egger检验的P值0. 05）。跨外科专业的证据表明，使用斯台普斯闭合伤口可缩短平均手术时间。尽管纳入了数千项观察结果，但在手术部位感染、术后并发症或住院时间方面，没有明确的证据表明斯台普斯或缝线具有优效性。
To systematically evaluate the evidence across surgical specialties as to whether staples or sutures better improve patient and provider level outcomes. A systematic review of systematic reviews and panoramic meta-analysis of pooled estimates. Eleven systematic reviews, including 13,661 observations, met the inclusion criteria. In orthopaedic surgery sutures were found to be preferable, and for appendicial stump sutures were protective against both surgical site infection and post surgical complications. However, staples were protective against leak in ilecolic anastomosis. For all other surgery types the evidence was inconclusive with wider confidence intervals including the possibly of preferential outcomes for surgical site infection or post surgical complication for either staples or sutures. Whilst reviews showed substantial variation in mean differences in operating time (I2 94%) there was clear evidence of a reduction in average operating time across all surgery types. Few reviews reported on length of stay, but the three reviews that did (I2 0%, including 950 observations) showed a non significant reduction in length of stay, but showed evidence of publication bias (P-value for Egger test 0.05). Evidence across surgical specialties indicates that wound closure with staples reduces the mean operating time. Despite including several thousand observations, no clear evidence of superiority emerged for either staples or sutures with respect to surgical site infection, post surgical complications, or length of stay.
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影响因子：
6.9
作者：
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通讯作者：
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影响因子：
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作者：
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发表时间：
2006-09-01
影响因子：
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作者：
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