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This meta-analysis investigates the effect of dexmedetomidine on postoperative wound healing in neurosurgical patients. A thorough literature search resulted in the selection of seven studies from an initial pool of 1546 records. The analysis focused on wound healing outcomes, evaluated by the Redness, Oedema, Ecchymosis, Discharge, Approximation (REEDA) scale and the Manchester Scar Scale (MSS). Results indicated significant improvements in the dexmedetomidine group: the REEDA scale scores at day seven post-surgery showed a Standardized Mean Difference group (SMD = −16.18, 95% CI: [−22.30, −10.06], p < 0.01), and the MSS scores at 3 months post-operation demonstrated an (SMD = −8.95, 95% CI: [−14.27, −3.62], p < 0.01). These findings suggest that dexmedetomidine may enhance wound healing and reduce scar formation in neurosurgical patients. Bias assessment indicated a low risk of bias across the studies.
It is still a matter of controversy whether percutaneous endoscopic gastrostomy(PEG) should be used prior to the operation for the purpose of feeding the patient with resectable oesophageal carcinoma (EC). Comparison was made between EC and preoperatively treated PEG and non-preoperative PEG. An extensive literature review has been conducted to determine the results about PEG and No-PEG trials. In this paper, we chose 4 papers out of 407 of them through a strict selection process. In this trial, there were 1027 surgical cases of oesophagus carcinoma, 152 with PEG pre-surgery and 875 without PEG. The total sample size ranged from 14 to 657. Two studies showed that there was no statistically significant difference in the occurrence of postoperative wound infection among PEG and No-PEG(OR, 1.03; 95% CI, 0.38, 2.80 p = 0.96), there was no statistical significance in the likelihood of anastomotic leak among PEG after surgery compared to No-PEG in 4 trials (OR, 1.13; 95% CI, 0.62–2.07 p = 0.69), and there were no statistical differences between PEG and No-PEG before operation on anastomotic stricture for esophagectomy(OR, 0.70; 95% CI, 0.31–1.56 p = 0.38). No wound or anastomosis complications were observed in the PEG group. Thus, PEG preoperatively is an effective and safe procedure without any harmful influence on gastrointestinal structure or anastomosing. It can be applied to patients with oesophagus carcinoma who have a high risk of undernutrition. Nevertheless, because of the limited number of randomized controlled trials in this meta-analysis, caution should be exercised in their treatment. More high-quality research involving a large sample is required to confirm the findings.
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.
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