Conectar
A meta-analysis research was implemented to appraise the perineal wound complications (PWCs) after vertical rectus abdominis myocutaneous (VRAM) flap and mesh closure (MC) following abdominoperineal surgery (AS) and pelvic exenteration (PE) of anal and rectal cancers. Inclusive literature research till April 2023 was done and 2008 interconnected researches were revised. Of the 20 picked researches, enclosed 2972 AS and PE of anal and rectal cancers persons were in the utilized researchers' starting point, 1216 of them were utilizing VRAM flap, and 1756 were primary closure (PC). Odds ratio (OR) and 95% confidence intervals (CIs) were utilized to appraise the consequence of VRAM flap in treating AS and PE of anal and rectal cancers by the dichotomous approach and a fixed or random model. VRAM flap had significantly lower PWCs (OR, 0.64; 95% CI, 0.42–0.98, p < 0.001), and major PWCs (OR, 0.50; 95% CI, 0.32–0.80, p = 0.004) compared to PC in AS and PE of anal and rectal cancers persons. However, VRAM flap and PC had no significant difference in minor PWCs (OR, 1; 95% CI, 0.54–1.85, p = 1.00) in AS and PE of anal and rectal cancer persons. VRAM flap had significantly lower PWCs, and major PWCs, however, no significant difference was found in minor PWCs compared to PC in AS and PE of anal and rectal cancers persons. However, caution needs to be taken when interacting with its values since there was a low sample size of most of the chosen research found for the comparisons in the meta-analysis.
The application of infrared thermography technology (IRT) in flap has become a major focus of research, as it provides a non-invasive, real-time, and quantitative approach for monitoring flap perfusion. In this regard, we conducted a comprehensive visualization and scientometric analysis to systematically summarize and discuss the current state of research in this field. We systematically reviewed publications on the application of IRT in flap procedures from 1999 to 2022, using the Web of Science Core Collection (WoSCC). Through scientometric analysis, we examined annual trends, affiliations, countries, journals, authors, and their relationships, providing insights into current hotspots and future developments in this area. We analysed 522 English studies and found a steady increase in annual publications. The United States and Germany had the highest publication rates, with Beth Israel Deaconess Medical Center and Shanghai Jiaotong University being leading institutions. Notably, Lee BT and Alex Keller emerged as influential authors in this field. Compared to existing techniques, infrared-based technology offers significant advantages for non-invasive monitoring of flap perfusion, including simplicity of operation and objective results. Future trends should focus on interdisciplinary collaborations to develop new infrared devices and achieve intelligent image processing, enabling broader application in various clinical scenarios. This bibliometric study summarizes the progress and landscape of research on ‘the Application of infrared thermography technology in flap’ over the past two decades, providing valuable insights and serving as a reliable reference to drive further advancements and spark researchers' interest in this field.
This study aimed to explore the relationship between diabetic retinopathy (DR) and diabetic foot ulcers (DFUs) to provide evidence for the prevention of diabetic complications. PubMed, EMBASE, Web of Science, Cochrane Library, China National Knowledge Infrastructure, Chinese Biomedical Literature Database and Wanfang Data databases were searched from their inception until March 2023 for studies on the relationship between DR and DFU. Two researchers independently screened the literature and extracted data according to the inclusion and exclusion criteria. The meta-analysis was performed using the RevMan 5.3 software. Eleven articles referring to 10 208 patients were included, of whom 2191 patients had DFU and 8017 patients did not have DFU. The meta-analysis results showed that DR significantly increased the incidence of DFU (47.94% vs. 16.38%; OR, 4.13; 95% CI, 2.33–7.33; p < 0.001). The results of this study suggest that patients with DR have a higher risk of developing DFU, highlighting the importance of regular screening for these two complications to prevent serious adverse outcomes of diabetes. However, further high-quality studies are required to validate the conclusions of the present study.
To providing evidence-based recommendations for surgery in patients with femoral neck fractures, a meta-analysis was conducted to comprehensively evaluate the effects of cemented and uncemented prostheses on postoperative surgical site wound infection and pain in these patients. Relevant studies on the use of cemented prostheses in femoral neck fractures were retrieved from PubMed, EMBASE, Cochrane Library, Ovid, CNKI, and Wanfang databases from the time of their establishment until March 2023. Two authors independently screened and extracted data from the included and excluded literature according to predetermined criteria. Review Manager 5.4 software was used to perform meta-analyses on the collected data. A total of 27 articles comprising 34 210 patients (24 646 cases in the cemented group and 9564 cases in the uncemented group) were included in the final analysis. The results of the meta-analysis showed that, compared with the uncemented group, cemented prostheses significantly reduced the incidence of surgical site wound infections (odds ratio [OR]: 0.75, 95% confidence interval [CI]: 0.64–0.88, p < 0.001) and relieved surgical site wound pain (standardised mean difference: −0.76, 95% CI: −1.12–0.40, p < 0.001), but did not reduce the incidence of pressure ulcers after surgery (OR: 0.50, 95% CI: 0.20–1.26, p = 0.140). Therefore, existing evidence suggests that the use of cemented prostheses in femoral neck fracture surgery can significantly reduce the incidence of surgical site wound infections and relieve surgical site wound pain, which is worthy of clinical recommendation.
The present study aimed to investigate the effect of local oxygen therapy combined with vacuum sealing drainage (VSD) on the healing of stage IV pressure ulcers sacrococcygeal. In this prospective study, we included a total of 98 patients with stage IV sacrococcygeal pressure ulcers in our hospital between February 2021 and June 2022. The patients enrolled were randomly and equally divided into two groups: the study group (undergoing local oxygen therapy combined with VSD treatment) and the control group (receiving conventional treatment). The wound healing time and hospital stay were compared between the two groups. Additionally, the wound area, tissue type, wound exudation and pain intensity were assessed before treatment, 10, 20, 30 and 40 days after treatment. The incidence of complications was also calculated. The study group demonstrated significantly shorter wound healing time and hospital stays compared to the control group (p < 0.05). Before treatment, there were no significant differences in terms of wound area, tissue type and wound exudation between the two groups (p > 0.05); after 10, 20, 30 and 40 days of treatment, however, evidently smaller wound areas, improved tissue types and reduced wound exudation were observed in the study group compared to the control group (p < 0.05). Furthermore, the study group exhibited increased microvascular count compared to the control group (p < 0.05). Before treatment, there was no significant difference in pain intensity between the two groups (p > 0.05), whereas markedly lower pain intensity was seen in the study group than in the control group after 10, 20, 30 and 40 days of treatment (p < 0.05). The incidence of complications did not significantly differ between the two groups after 40 days of treatment (p > 0.05). Local oxygen therapy combined with VSD was found to effectively accelerate the healing process of stage IV sacrococcygeal pressure ulcers, leading to shorter hospital stays and improved patient prognosis. This combined therapy shows promise for widespread application in clinical practice.
Because of the difficult surgical procedures, patients with lung cancer who have received thoracic surgery tend to have postoperative complications. It may lead to postoperative complications like wound infection, wound haematoma and pneumothorax. A lot of research has assessed the effect of various surgery methods on postoperative complications in pulmonary cancer. The purpose of this meta-analysis is to establish if thoracoscopic is superior to that of thoracotomy in the rate of post-operative complications. From the beginning to the end of June 2023, we performed an exhaustive search on four main databases for key words. The Hazard of Bias in Non-Randomized Interventional Studies (ROBINS-I) was evaluated in the literature. In the end, 13 trials that fulfilled the eligibility criteria underwent further statistical analyses. The results showed that thoracoscopic intervention decreased the risk of post operative wound infection (dominant ratio [OR], 3.00; 95% confidence margin [CI], 1.98, 4.55; p < 0.00001) and air-leakage after operation (OR, 1.30; 95% CI, 1.04, 1.63; p = 0.02). There was no statistically significant difference between the two groups in terms of the rate of haemorrhage after operation (OR, 0.10; 95% CI, 0.73, 1.66; p = 0.63). Our findings indicate that thoracoscopic is less likely to cause post operative infection and gas leakage than thoracotomy, and it does not decrease the risk of postoperative haemorrhage. As some of the chosen trials are too small to conduct meta-analyses, care must be taken when handling the data. In the future, a large number of randomized, controlled trials will be required to provide additional evidence for this research.
In this clinical trial, we investigated the efficacy of two treatment methods for keloids resulting from surgical incisions: intralesional triamcinolone injections alone versus in combination with verapamil.
Patients were divided into two groups: one received triamcinolone alone (Group T) and the other received a triamcinolone-verapamil blend (Group VT). Regular treatments were conducted until the keloids were nearly flat or for a maximum of eight sessions.
Both groups showed significant improvements, but Group VT saw quicker resolution of skin redness and needed fewer sessions. Though the Vancouver Scar Scale (VSS) scores were generally similar across both groups, Group VT exhibited greater improvements, leading to lower final scores. The VT group also attained normal scar flexibility faster than the T group.
These findings suggest that the combination of verapamil and triamcinolone provides a more effective treatment for keloids, thereby highlighting the potential of verapamil in scar reduction.
This study aimed to produce zinc oxide nanoparticles with Calendula officinalis flower extract (Co-ZnO NPs) using the green synthesis method. In addition, the antioxidant and wound healing potential of synthesized ZnO NPs were evaluated. The absorbance band at 355 nm, which is typical for ZnO NPs, was determined from the UV–Vis absorbance spectrum. The energy-dispersive X-ray spectroscopy (EDS) measurements revealed a high zinc content of 42.90%. The x-ray diffractometer data showed Co-ZnO NPs with an average crystallite size of 17.66 nm. The Co-ZnO NPs did not have apparent cytotoxicity up to 10 μg/mL (IC50 25.96 μg/mL). C. officinalis ZnO NPs showed partial cell migration and percent wound closure (69.1%) compared with control (64.8%). In addition, antioxidant activities of Co-ZnO NPs with 2,2'-azino-bis(3-ethylbenzothiazoline-6-sulfonic acid) (ABTS) and 2,2 diphenyl-1 picrylhydrazil (DPPH) were evaluated and radical scavenging activity of 33.49% and 46.63%, respectively, was determined. These results suggest that C. officinalis extract is an effective reducing agent for the green synthesis of ZnO NPs with significant antioxidant and wound healing potential.
To summarise research studies on scar laser therapy since the 21st century using bibliometric methods, and to speculate on the possible development in the future. The literature about scar laser therapy in Web of Science database was searched. CiteSpace and VOSviewer were used to analyse main countries, institutions, journals，subject hotspots and trends, etc. A total of 884 papers have been published since the 21st century. These publications were written by 653 authors from 515 institutions in 58 countries. The United States published 287 papers in this field and ranks first. Laser in Surgery and Medicine is the most widely published journal, with Shumaker as the core author. The main keyword clustering includes terms such as combination therapy, wound healing, fractional photothermolysis, experience, scar formation, etc. CiteSpace and VOSviewer were used to sort out and summarise the countries, institutions, authors, journals, research hotspots and frontier topics of related literature about scar laser therapy since the 21st century. The current situation of its application and basic scientific research in clinical treatments were summarised briefly. This provides a new idea for the development and research of scar laser therapy in the future.
This analysis systematically reviewed the efficacy of evidence-based care on diabetic foot ulcers. A computerised literature search was conducted for randomised controlled studies (RCTs) of evidence-based care interventions for the treatment of diabetic foot ulcers using the PubMed, Embase, Cochrane Library, Web of Science, China National Knowledge Infrastructure (CNKI), China Biomedical Literature Database (CBM) and Wanfang databases from the date of inception of each database to June 2023. The articles were independently screened, data were extracted by two researchers, and the quality of each study was assessed using the Cochrane bias assessment tool. Meta-analysis of the data was performed using RevMan 5.4 software. Twenty-five RCTs with a total of 2272 patients were included. Meta-analysis showed that, compared with other care methods, evidence-based care significantly improved the treatment efficacy of diabetic foot ulcers (odds ratio: 3.91, 95% confidence interval [CI]: 2.76 to 5.53, p < 0.001) and significantly reduced their fasting plasma glucose (mean difference [MD]: −1.10, 95% CI: −1.24 to −0.96, p < 0.001), 2-h postprandial glucose (2hPG) (MD: −1.69, 95% CI: −2.07 to −1.31, p < 0.001) and glycated haemoglobin (HbA1c) (MD: −0.71, 95% CI: −0.94 to −0.48, p < 0.001). Evidence-based care intervention is effective at reducing FPG, 2hPG and HbA1c levels and improving treatment efficacy in patients with diabetic foot ulcers.
Tracheostomy is one of the most common operations. The two main methods of tracheostomy are open surgical tracheostomy (OST) and percutaneous dilatational tracheostomy (PDT). In critical cases, the combination of these two approaches is especially crucial, with the possibility of successful outcomes and low complications. Thus, the purpose of this system is to analyse the effects of both methods on the outcome of postoperative wound. In this research, we performed a systematic review of Cochrane Library, PubMed, Web of Science and Embase, to determine all randomized controlled trials (RCTs) that are comparable in terms of postoperative injury outcomes. Eleven RCTs were found after screening. This study will take the necessary data from the selected trials and evaluate the documentation for RCTs. PDT was associated with a lower incidence of infection at the wound site than OST (OR, 4.46; 95% CI: 2.84–7.02 p < 0.0001), and PDT decreased blood loss (OR, 2.88; 95% CI: 1.62–5.12 p = 0.0003). But the operation time did not differ significantly in both PDT to OST (MD, 4.65; 95% CI: −1.19–10.48 p = 0.12). The meta-analyses will assist physicians in selecting the best operative procedure for critical cases of tracheostomy. These data can serve as guidelines for clinical management and in the design of future randomized, controlled studies.
Fast track surgery (FTS) is widely used in many procedures and has been shown to reduce complications and accelerate recovery. However, no studies have been conducted to assess their effectiveness in treating wounds after radical prostatectomy (RP). The objective of this study was to evaluate the impact of FTS on RP. We went through 4 major databases. A study was conducted by PubMed, the Cochrane Library, Embase, and the Web of Science to determine the effect of comparison of FTS versus conventional surgery in RP on postoperative wound complications as of 1 July 2023. Based on the review of literature, data extraction and literature quality assessment, we conducted meta-analyses with RevMan 5.3. In the course of the study, the researchers selected 6 of the 404 studies to be analysed according to exclusion criteria. Data analysis showed that the FTS method reduced the postoperative pain associated with VAS and also decreased the rate of postoperative complications in post-surgical patients. However, there was no significant difference between FTS and conventional surgery in terms of blood loss, operation time, and postoperative infection rate. Therefore, generally speaking, FTS has less impact on postoperative complications in patients with minimal invasive prostatic cancer, but it does reduce postoperative pain and total postoperative complications.
We examined whether small incision aortic root replacement could reduce the amount of blood transfusion during operation and the risk of postoperative complications. An extensive e-review of the 4 main databases (PubMed, Cochrane, Web of Science and EMBASE) was carried out to determine all the published trials by July 2023. The search terms used were associated with partial versus full sternotomy and aortic root. This analysis only included the study articles that compared partial and full sternotomy. After excluding articles based on titles or abstracts, selected full-text articles had reference lists searched for any potential further articles. We analysed a total of 2167 subjects from 10 comparable trials. The minimally invasive aortic root graft in breastbone decreased the duration of hospitalization (MD, −2.58; 95% CI, −3.15, −2.01, p < 0.0001) and intraoperative red blood cell transfusion (MD, −1.27; 95% CI, −2.34, −0.19, p = 0.02). However, there were no significant differences in wound infection (OR, 0.88; 95% CI, 0.16, 4.93, p = 0.88), re-exploration for bleeding (OR, 0.96; 95% CI, 0.60, 1.53, p = 0.86), intraoperative blood loss (MD, −259.19; 95% CI, −615.11, 96.73, p = 0.15) and operative time (MD, −7.39; 95% CI, −19.10, 4.32, p = 0.22); the results showed that the microsternotomy did not differ significantly from that of the routine approach. Small sternotomy may be an effective and safe substitute for the treatment of the aorta root. Nevertheless, the wide variety of data indicates that larger, well-designed studies are required to back up the current limited literature evidence showing a benefit in terms of complications like postoperative wound infections or the volume of intraoperative red blood cell transfusion.
We conducted a comprehensive analysis to evaluate the benefits of negative pressure wound therapy (NPWT) versus traditional dressings in preventing surgical site infections in patients undergoing cardiac surgery. We thoroughly examined several databases, including PubMed, EMBASE, Cochrane Library, China National Knowledge Infrastructure (CNKI), VIP, Chinese Biomedical Literature Database (CBM) and Wanfang, from inception until July 2023. Two independent researchers were responsible for the literature screening, data extraction and quality assessment; analyses were performed using RevMan 5.4 software. Thirteen studies comprising 8495 patients were deemed relevant. A total of 2685 patients were treated with NPWT, whereas 5810 received conventional dressings. The findings revealed that NPWT was more effective in reducing surgical site infections after cardiac surgery than conventional dressings (4.88% vs. 5.87%, odds ratio [OR]: 0.50, 95% confidence intervals [CIs]: 0.40–0.63, p < 0.001). Additionally, NPWT was more effective in reducing deep wound infections (1.48% vs. 4.15%, OR: 0.36, 95% CI: 0.23–0.56, p < 0.001) and resulted in shorter hospital stays (SMD: -0.33, 95% CIs: −0.54 to −0.13, p = 0.001). However, the rate of superficial wound infections was not significantly affected by the method of wound care (3.72% vs. 5.51%, OR: 0.63, 95% CI: 0.32–1.23, p = 0.180). In conclusion, NPWT was shown to be advantageous in preventing postoperative infections and reducing hospital stay durations in patients undergoing cardiac surgery. Nonetheless, given the limitations in the number and quality of the included studies, further research is recommended to validate these findings.
This meta-analysis aimed to compare laparoscopic hysterectomy (LH) and open hysterectomy (OH) in terms of surgical site wound infection, length of hospital stay, and postoperative complications in patients with endometrial cancer (EC). PubMed, Embase, Cochrane Library, China National Knowledge Infrastructure, VIP, and Wanfang databases were comprehensively searched for studies on OH and LH for EC published between 2008 and July 2023, in any language. The literature was screened according to the inclusion and exclusion criteria, and the quality of the included case–control studies was assessed using the Newcastle-Ottawa Scale. Data were collated and analysed using Stata 17.0 software. A total of 1245 articles were screened according to the search strategy, and ultimately 15 studies were included in this meta-analysis, with a total of 1606 patients with EC, of which 751 were treated with LH and 855 with OH. The results showed that the rate of postoperative wound infection was significantly higher (OR: 0.290; 95% CI: 0.169–0.496, p < 0.001), the length of hospital stay was significantly longer (SMD: −1.976, 95% CI: −2.669 to −1.283, p < 0.001), and the incidence of postoperative complications was significantly higher (OR: 0.366; 95% CI: 0.280–0.478, p < 0.001) in the OH group than in the LH group. This study showed that LH was superior to OH for the treatment of EC and is associated with a lower rate of wound infection, shorter length of hospitalisation, and a reduced risk of complications. Thus, our findings support the choice of LH over OH for EC.
In this study, a meta-analysis was conducted to assess the effect of refined nursing interventions in the operating room on the incidence of surgical-site wound infections in patients undergoing lung cancer surgery to provide an evidence base for the prevention and management of nosocomial infections. A computerised literature search was used to identify randomised controlled trials (RCTs) on the application of refined nursing interventions in the operating room in patients undergoing lung cancer surgery published in the PubMed, EMBASE, Cochrane Library, China National Knowledge Infrastructure (CNKI), VIP and Wanfang databases from their inception until July 2023. The literature screening, data extraction and quality assessment of the included studies were performed independently by two researchers. RevMan 5.4 software was used for the meta-analysis. Twenty-eight studies were included in the analysis, with a total of 2406 patients, including 1210 patients in the refined nursing intervention group and 1196 patients in the control group. The results of the meta-analysis showed that the refined nursing interventions in the operating room significantly reduced the incidence of surgical-site wound infections in patients undergoing lung cancer surgery, compared with the control group (1.82% vs. 6.52%, odds ratio: 0.30, 95% CI: 0.19–0.47, p < 0.001), and shortened the length of hospital stay (standardised mean difference: −1.51 days, 95% CI: −1.92 to −1.11 days, p < 0.001). Current evidence suggests that the application of refined nursing interventions in the operating room is effective at reducing the incidence of surgical-site wound infections and shortening the length of hospital stay in patients undergoing lung cancer surgery. However, owing to the small number and low quality of the studies, more high-quality RCTs with large sample sizes are needed to confirm these results.
The current methods for the prediction of mortality and amputation for inpatients with diabetic foot (DF) use only conventional, simple variables, which limits their performance. Here, we used a random survival forest (RSF) model and multicomponent variables to improve the prediction of mortality and amputation for these patients. We performed a retrospective cohort study of 175 inpatients with DF who were recruited between 2014 and 2021. Thirty-one predictors in six categories were considered as potential covariates. Seventy percent (n = 122) of the participants were randomly selected to constitute a training set, and 30% (n = 53) were assigned to a testing set. The RSF model was used to screen appropriate variables for their value as predictors of 2-year all-cause mortality and amputation, and a multicomponent prediction model was established. Model performance was evaluated using the area under the curve (AUC) and the Hosmer–Lemeshow test. The AUCs were compared using the Delong test. Seventeen variables were selected to predict mortality and 23 were selected to predict amputation. Uric acid and alanine transaminase were the top two most useful variables for the prediction of mortality, whereas urine protein and platelet were the top variables for the prediction of amputation. The AUCs were 0.913 and 0.851 for the prediction of mortality for the training and testing sets, respectively; and the equivalent AUCs were 0.963 and 0.893 for the prediction of amputation. There were no significant differences between the AUCs for the training and testing sets for both the mortality and amputation models. These models showed a good degree of fit. Thus, the RSF model can predict mortality and amputation in inpatients with DF. This multicomponent prediction model could help clinicians consider predictors of different dimensions to effectively prevent DF from clinical outcomes .
The Latarjet procedure is the accepted method of operation for patients with anterior shoulder instability. However, as arthroscopy becomes more and more popular, more and more patients are being treated with minimally invasive techniques for the treatment of anteriorly unstable shoulder. This research aims to compare the curative effects of arthroscopic Latarjet (AL) and open Latarjet (OL) on postoperative anterior shoulder instability. Our hypothesis is that arthroscopy will produce better results than open surgery. During the study, a review was conducted on four main databases, including EMBASE and Cochrane Library. Six cohort studies comparing AL with OL in the treatment of anterior shoulder instability were included. Patients who were operated by open technique up to 2023 were referred to as OL and those who underwent arthroscopic surgery were referred to as AL. Comparison was made between the two methods of operation. The statistical analysis was done with RevMan 5.3. The analysis included Visual Analogue Scale (VAS) scores and postoperative wound infections. A total of six studies were included for analysis under inclusion and exclusion criteria. There were 798 patients, 476 was AL group and 322 was OL group. No statistical significance was found on the incidence of postoperative wound infection in the patients who underwent the Latarjet procedure (odds ratio [OR], 1.43; 95% confidence interval [CI], 0.28–7.31; p = 0.67) and the VAS score after surgery (mean difference [MD], 0.70; 95% CI, −0.67 to 2.06; p = 0.32) for patients. However, it has now been demonstrated that arthroscopy is a safe and viable alternative. The only drawback of arthroscopic Latarjet surgery is probably that it has a long learning curve and requires a lot of practice from the surgeon.
A systematic evaluation was conducted to assess the efficacy of two disinfectants, chlorhexidine and povidone-iodine, as primary components in preventing surgical site infection (SSI). A comprehensive computerised search was performed in the PubMed, EMBASE, Web of Science, Cochrane Library, CNKI and Wanfang databases for randomised controlled trials (RCTs) on chlorhexidine and povidone-iodine disinfection for the prevention of SSI from inception until July 2023. Two independent researchers completed literature screening, data extraction and quality assessment of the included studies. The meta-analysis was conducted using RevMan 5.4 software. Ultimately, 20 RCTs were included, which included 13 133 patients, with 6460 patients in the chlorhexidine group and 6673 patients in the povidone-iodine group. The meta-analysis results revealed that the incidence rate of surgical site wound infections [odds ratio (OR): 0.67, 95% confidence interval (CI): 0.58–0.78, p < 0.001)], superficial SSI rate (OR: 0.59, 95% CI: 0.46–0.75, p < 0.001) and deep SSI rate (OR: 0.49, 95% CI: 0.31–0.79, p = 0.003) were all lower in patients subjected to chlorhexidine disinfection compared to those patients receiving povidone-iodine disinfection. Existing evidence suggests that chlorhexidine is more effective than povidone-iodine at preventing SSI. However, owing to the potential quality limitations of the included studies, further validation through high-quality large-scale RCTs is warranted.
FreshRSS 