Efficacy and safety of external tissue expansion technique in the treatment of soft tissue defects: a systematic review and meta-analysis of outcomes and complication rates.
Efficacy and safety of external tissue expansion technique in the treatment of soft tissue defects: a systematic review and meta-analysis of outcomes and complication rates.
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DOI：
10.1093/burnst/tkac045
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发表时间：
2022
期刊：
影响因子：
5.3
通讯作者：
Xia, Zhaofan
中科院分区：
文献类型：
--
作者：
Tong, Xirui;Lu, Jianyu;Zhang, Wei;Wang, Siqiao;Huang, Runzhi;Zhang, Xianliang;Huang, Jie;Zhu, Yushu;Xiao, Shichu;Ji, Shizhao;Xia, Zhaofan
关键词：
目前，各种外部组织扩张装置正被广泛使用。考虑到相关应用标准的缺乏，本系统评价旨在探讨外部组织扩张技术用于软组织缺损重建的有效性和安全性。对体外组织扩张技术的有效性和安全性进行了系统综述和荟萃分析。在以下电子数据库中进行了全面检索：PubMed/Medline、Embase、科克伦图书馆（Wiley在线图书馆）和Web of Science。纳入了报告采用外部组织扩张技术治疗软组织缺损患者的研究。共有66项研究（22种不同类型的外部组织扩张器）符合入选标准。我们对不同类型的器械进行了描述性分析。进行了单组荟萃分析，以评价外部组织扩张技术对不同病因的有效性和安全性。筋膜切开术后缺损患者的汇总平均伤口愈合时间为10.548天[95%置信区间（CI）= 5.796-15.299]。切除术后缺损、创伤、慢性溃疡和腹部缺损患者的合并中位伤口愈合时间为11.218天（95%CI = 6.183-16.253）、11.561天（95%CI = 7.062-16.060）、15.956天（95%CI = 11.916-19.996）和12.853天（95%CI =9.444-16.227）。筋膜切开术、切除术、创伤、慢性溃疡和腹部缺损后缺损患者的合并伤口愈合率为93.8%（95%CI =87.1-98.2%）、97.2%（95%CI=92.2-99.7%）、97.0%（95%CI=91.2-99.8%）、99.5%（95%CI=97.6-100%）和96.8%（95%CI=79.2-100%）。我们对糖尿病溃疡和腹部开放性伤口患者进行了亚组分析。糖尿病溃疡患者的合并中位伤口愈合时间为11.730天（95% CI = 10.334-13.125）。开放性腹部缺损患者的合并中位伤口愈合时间为48.810天（95% CI = 35.557-62.063），合并成功愈合率为68.8%（95% CI = 45.9-88.1%）。共纳入1686例患者，其中265例（15.7%）发生并发症。最常见的并发症是裂开（n = 53，3.14%）。我们的系统性综述首次证明了外部组织扩张术在软组织缺损治疗中的有效性和安全性。然而，考虑到本综述的局限性，我们必须谨慎解释荟萃分析结果。其疗效及愈合质量尚需大规模随机对照试验及长期随访研究证实。
Currently, various external tissue expansion devices are becoming widely used. Considering the scarcity of relevant application standards, this systematic review was performed to explore the effectiveness and safety of external tissue expansion techniques for the reconstruction of soft tissue defects. A systematic review and meta-analysis on the efficacy and safety of external tissue expansion technique was conducted. A comprehensive search was performed in the following electronic databases: PubMed/Medline, Embase, Cochrane Library (Wiley Online Library), and Web of Science. Studies reporting patients with soft tissue defects under the treatment of external tissue expansion technique were included. A total of 66 studies with 22 different types of external tissue expansion devices met the inclusion criteria. We performed a descriptive analysis of different kinds of devices. A single-arm meta-analysis was performed to evaluate the efficacy and safety of the external tissue expansion technique for different aetiologies. The pooled mean wound healing time among patients with defects after fasciotomy was 10.548 days [95% confidence interval (CI) = 5.796–15.299]. The pooled median wound healing times of patients with defects after excisional surgery, trauma, chronic ulcers and abdominal defects were 11.218 days (95% CI = 6.183-16.253), 11.561 days (95% CI = 7.062-16.060), 15.956 days (95% CI = 11.916-19.996) and 12.853 days (95% CI=9.444-16.227), respectively. The pooled wound healing rates of patients with defects after fasciotomy, excisional surgery, trauma, chronic ulcers and abdominal defects were 93.8% (95% CI=87.1-98.2%), 97.2% (95%CI=92.2-99.7%), 97.0% (95%CI=91.2-99.8%), 99.5% (95%CI=97.6-100%), and 96.8% (95%CI=79.2-100%), respectively. We performed a subgroup analysis in patients with diabetic ulcers and open abdominal wounds. The pooled median wound healing time of patients with diabetic ulcers was 11.730 days (95% CI = 10.334-13.125). The pooled median wound healing time of patients with open abdomen defects was 48.810 days (95% CI = 35.557–62.063) and the pooled successful healing rate was 68.8% (95% CI = 45.9-88.1%). A total of 1686 patients were included, 265 (15.7%) of whom experienced complications. The most common complication was dehiscence (n = 53, 3.14%). Our systematic review is the first to demonstrate the efficacy and safety of external tissue expansion in the management of soft tissue defects. However, we must interpret the meta-analysis results with caution considering the limitations of this review. Large-scale randomized controlled trials and long-term follow-up studies are still needed to confirm the effectiveness and evaluate the quality of healing.
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影响因子：
15.8
作者：
Moher D;Liberati A;Tetzlaff J;Altman DG;PRISMA Group
通讯作者：
PRISMA Group
DOI：
10.3109/17453679608994668
发表时间：
1996-04-01
期刊：
ACTA ORTHOPAEDICA SCANDINAVICA
影响因子：
--
作者：
Bjarnesen, JP;Wester, JU;Jensen, NK
通讯作者：
Jensen, NK
影响因子：
2.6
作者：
Futran, ND
通讯作者：
Futran, ND
影响因子：
1.5
作者：
Asgari, MM;Spinelli, HM
通讯作者：
Spinelli, HM
影响因子：
2.1
作者：
Bonaparte, J. P.;Corsten, M.;Allen, M.
通讯作者：
Allen, M.