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Simplified dressing change after surgery for high anal fistula: A prospective, single centre randomized controlled study on loose combined cutting seton (LCCS) technique

Abstract

Background

Dressing change is the most important part of postoperative wound care. The aim of this study was to evaluate whether a more effective, simple and less painful method of dressing change for anal fistulas could be found without the need for debridement and packing. Data related to postoperative recovery were recorded at postoperative days 3, 7, 14, 21 and 180.

Methods

In this experiment, 76 subjects diagnosed with high anal fistula were randomly divided into a simplified dressing change (SDC) group and a traditional debridement dressing change(TDDC) group according to a ratio of 1:1.

Results

The SDC group had significantly fewer pain scores, bleeding rates, dressing change times, inpatient days and lower average inpatient costs than the TDDC group. There were no significant differences in wound healing time, area and depth and Wexner score between the two groups.

Conclusions

Studies have shown that the use of simplified dressing changes does not affect cure or recurrence rates, but significantly reduces dressing change times and pain during changes, reducing patient inpatient length of stay and costs.

Impact of type 2 diabetes on surgical site infections and prognosis post orthopaedic surgery: A systematic review and meta‐analysis

Abstract

Background

The escalating prevalence of type 2 diabetes raises concerns about adverse postoperative outcomes like surgical site infections (SSIs) and deep vein thrombosis (DVT) in orthopaedic surgeries. This meta-analysis aims to resolve inconclusive evidence by systematically quantifying the risks in type 2 diabetic patients compared to non-diabetic individuals.

Methods

The meta-analysis was conducted adhering to the PRISMA guidelines and based on the PICO framework. Four primary databases were searched: PubMed, Embase, Web of Science and the Cochrane Library, with no temporal restrictions. Studies included were either prospective or retrospective cohort studies published in English or Chinese, which assessed orthopaedic surgical outcomes among adult type 2 diabetic and non-diabetic patients. The meta-analysis employed the Newcastle–Ottawa Scale for quality assessment and used both fixed-effect and random-effects models for statistical analysis based on the level of heterogeneity.

Results

Out of 951 identified articles, nine studies met the inclusion criteria. The odds ratio (OR) for developing postoperative SSIs among diabetic patients was 1.63 (95% CI: 1.19–2.22), indicating a significantly elevated risk compared to non-diabetic subjects. Conversely, no statistically significant difference in the risk of postoperative DVT was found between the two groups (OR: 0.82; 95% CI: 0.55–1.22). Sensitivity analysis confirmed the stability of these outcomes.

Conclusions

Patients with type 2 diabetes are at a higher risk of developing SSIs post orthopaedic surgery compared to non-diabetic individuals. However, both groups demonstrated comparable risks for developing postoperative DVT.

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