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At present, it is still controversial whether patients in intensive care unit (ICU) use tracheal intubation with or without cuff. This paper evaluates the effect of tracheal intubation with and without cuff on overall complication rate of patients with intubation in ICU. The database of PubMed, Embase, Conchrane Library and Web of Science was searched by computer, and the clinical research on intubation with and without cuff in ICU was collected. The time range was from the database establishment to November 2023. Literature was independently screened, information was extracted, and quality was assessed by two researchers. Finally, there were nine studies included, with 11 068 patients (7391 in cuff group and 3677 in non-cuff group). The results showed that the overall complication rate of cuff group was significantly lower than that of non-cuff group, and that of cuff group (RR = 0.53, p < 0.01). In addition, compared with the non-cuff group, the cuff group had a lower number of tracheal intubation changes [RR = 0.05, p < 0.01] and a lower incidence of aspiration pneumonia (RR = 0.45, p = 0.01). Compared with the non-cuff group, the cuff group had a higher incidence of oral mucosal ulcers and pharyngitis (RR = 1.99, p = 0.04), while the cuff group had a lower incidence of laryngeal edema (RR = 0.39, p < 0.01). In ICU intubation patients, the use of cuffs reduces overall complication rate in comparison to patients without cuffs. Therefore, patients with intubation in ICU can recommend tracheal intubation with cuff.
This study was conducted to determine whether Naoxintong capsules may enhance wound healing and reduce postoperative complications in individuals having craniotomies. A total of 120 patients at Tongji Hospital, Shanghai, participated in this clinical perspective study conducted from April 2022 to June 2023. Participants were divided into treatment group (n = 60), receiving standard care plus Naoxintong capsules and control group (n = 60), receiving standard care only. Primary outcomes included the rate of wound healing, while secondary outcomes encompassed postoperative complications and patient-reported outcomes on pain and quality of life. The treatment group exhibited significantly enhanced wound healing rate than the control at Day 7 (40.33 vs. 25.67%, p < 0.05), Day 14 (75.17 vs. 50.83%, p < 0.05) and Day 28 (94.83 vs. 79.50%, p < 0.05). Postoperative complications were markedly reduced in the treatment group, with lower rates of infection (p < 0.05), wound dehiscence (p < 0.05) and cerebrospinal fluid leakage (p < 0.05). Furthermore, patient-reported outcomes significantly favoured the treatment group, with reduced pain scores and improved quality of life at 4 weeks post-surgery(p < 0.05). Naoxintong capsules thus significantly enhanced the wound healing and reduced postoperative complications, contributing to improved patient-reported outcomes in post-craniotomy patients. These findings advocated for the integration of Naoxintong in postoperative care, highlighting the potential of traditional Chinese medicine in modern surgical recovery protocols. Further studies with larger cohorts are recommended to validate these findings and explore the underlying mechanisms.
Traditional Hartmann surgery is used when the patient is in an acute case where it might not be safe to carry out a one-stage intestinal anastomosis. Laparoscopy has been extensively applied in the treatment of large intestine, which can significantly improve both short- and long-term outcomes. While randomized, controlled studies and reviews have shown that laparoscopy is superior to that of open-access colectomy, the impact of Hartmann's surgery on postoperative site infections has not been studied. The purpose of this study is to summarize the existing evidence to show that laparoscopy is better than open operation in the area of injury. Methods The Embase, PubMed and Cochrane Libraries were searched from the moment the database was created until November 2023. For binary results, the odds ratio was estimated, and a weighted average of consecutive results was calculated. Our findings indicate that there is a lower risk for SSIs after laparoscopic approach surgery than an open-access procedure (OR, 0.26; 95% CI, 0.10, 0.69, p = 0.006); Laparoscopy was associated with a reduction in the risk of dying after surgery (OR, 0.50; 95% CI, 0.30, 0.84, p = 0.009); The operation time was not significantly different in open and laparoscope (MD, 12.23; 95% CI, −5.63, 30.09, p = 0.18); laparoscopy was used to lower the incidence of SSI after surgery and to lower the mortality rate after surgery than by open-access surgery. However, the time of operation did not differ significantly among the two methods. However, further controlled trials will need to be carried out to verify the results.
Surgical site infections (SSIs) pose a significant complication following laparoscopic urological surgeries, impacting patient recovery and healthcare resources. Understanding the pathogen distribution and identifying associated risk factors for SSIs is critical for improving surgical outcomes. A retrospective analysis was performed on 90 patients, from March 2020 to June 2023, to investigate the risk factors and pathogen profiles in SSIs post-laparoscopic urological procedures. Patients with documented infections were compared to a control group without SSIs. Data on demographics, comorbidities and perioperative variables were collected. Pathogens were identified using the VITEK-2 Compact system. Statistical analyses included univariate and multivariate logistic regression models. Upon evaluation, demographic and clinical characteristics showed no significant variance in patients with SSIs compared to those without such infections. The predominant pathogen identified was Escherichia coli. Administration of prophylactic antibiotics correlated with a reduced incidence of SSIs, whereas an array of risk factors including surgery duration of 2 h or more, anaemia, white blood cell counts exceeding 10 × 109/L, a history of urinary tract infections, the presence of diabetes mellitus and incidences of urinary leakage post-surgery were identified as contributors to a heightened risk of SSIs. Prophylactic antibiotics serve as a protective factor against SSIs, whereas several modifiable risk factors, including operation duration, anaemia, elevated leukocytes, history of urinary infections, diabetes and urinary leakage, contribute to the increased risk.
To evaluate the risk factors connected with diabetic foot care and investigate the impact of health education on promoting proper diabetic foot care practices. An explanatory and mixed-method study was performed. We administered a structured pretest questionnaire to patients diagnosed with Type 2 diabetes who frequented our health examination center and community health clinics. The survey encompassed patient demographics, basic knowledge concerning diabetic foot care, and self-care practices pertaining to diabetic foot care. Concurrent assessments and scoring were carried out. Following the survey, patients underwent health education sessions focusing on foot self-care behaviours. Their progress was reevaluated after 2 weeks to gauge its effectiveness. We identified educational attainment, diabetes duration, regular follow-up, and blood sugar control as critical factors influencing knowledge about foot care and self-care practices related to it. Pearson correlation analysis demonstrated a positive relationship between scores for diabetic foot care knowledge and scores for self-care behaviours (r = 0.32, p < 0.001). Health education led to a significant improvement in the self-care behaviours of diabetic patients. A variety of factors affect the occurrence of diabetic foot complications and the self-care behaviours associated with diabetic foot care. Health education proves to be an effective means of enhancing diabetic foot care behaviours.
We aim to evaluate the efficacy of sacral foam dressings in preventing sacral pressure injury.
The PubMed, Embase and Web of Science databases were searched for relevant publications until October 2023. All studies evaluating the efficacy of sacral foam dressings in preventing sacral pressure injury were included. We calculated pooled risk ratio (RR) with 95% confidence intervals (CIs) for binary outcomes. The Cochrane's Risk of Bias Tool were used to evaluate the quality of studies.
A total of 9 randomized controlled studies with 3972 patients were included in this analysis. Sacral pressure injury rate was significantly lower in the sacral foam dressing group compared with the standard care group (RR: 0.37, 95% CI: 0.17–0.82). Furthermore, the rate of ≥stage II sacral pressure injury was also significantly reduced (RR: 0.56, 95% CI: 0.37–0.83), along with a lower blanching erythema rate (RR: 0.64, 95% CI: 0.42–0.97). No obvious publication bias was observed in the funnel plot (Egger's p values = 0.91).
Sacral foam dressing significantly reduced the incidence of sacral pressure injuries, including those of stage II or higher, and blanching erythema when compared to standard care without sacral foam dressing. However, the results should be interpreted with cautious because of the observed heterogeneity and the diverse patient population. Further larger, well-designed randomized control studies are needed.
Wound healing is a complex process that can lead to hypertrophic scarring (HS) when dysregulated. The role of lncRNAs in this process is increasingly recognized, yet the specific contributions of lncRNA STX17-AS1 require elucidation. This study investigated the expression of STX17-AS1, its regulatory effects on miR-145-5p, and downstream targets, highlighting its impact on wound repair and HS development. In a cohort of 20 HS patients and 20 matched controls, we assessed the expression of STX17-AS1, miR-145-5p and PDK1 via real-time PCR and immunohistochemistry. We correlated these expressions with wound characteristics and analysed their regulatory impact on the PI3K/AKT pathway, crucial for cellular proliferation and migration in wound healing. Elevated levels of STX17-AS1 and miR-145-5p in patient samples were correlated with larger wound areas and slower healing rates, suggesting the regulatory imbalance in scar formation. The negative correlation of PDK1 expression with age and its positive association with wound size underscored its relevance in wound repair mechanisms. Functional analysis confirmed the interaction between STX17-AS1 and miR-145-5p and modulation of PDK1, indicating the potential disruption of the PI3K/AKT pathway in the wound healing process. The study identified lncRNA STX17-AS1 as the significant mediator in wound healing, with aberrations in its pathway correlating with impaired healing and HS. The findings proposed lncRNA STX17-AS1 and miR-145-5p as molecular targets to enhance wound healing and prevent pathological scarring, offering a new avenue for therapeutic advances in wound management and regenerative medicine.
Venous leg ulcers (VLUs) represent a substantial challenge within the healthcare landscape, thereby necessitating efficacious therapeutic strategies. Exercise has been investigated as a prospective intervention to bolster the management of VLUs. The objective of this comprehensive review is to systematically scrutinize and appraise the extant body of evidence pertaining to the impact of exercise on the treatment of patients diagnosed with VLUs. A comprehensive literature search was executed across multiple databases, encompassing PubMed, the Cochrane Library, Web of Science, Embase, and Google Scholar. The methodological rigour was evaluated utilizing the Assessment of Multiple Systematic Reviews 2 (AMSTAR-2) instrument, while the quality of the evidence was appraised via the Grading of Recommendations Assessment, Development and Evaluation (GRADE) classification system. The relative efficacy of exercise interventions on outcomes related to VLUs, including rates of wound healing, total range of motion in the ankle joint, and adherence rates, was synthesized. Data were consolidated employing fixed-effects models, and the impact of exercise on these outcomes was visually represented through the use of forest plots. The methodological foundation of this investigation comprised four systematic reviews and meta-analyses, each characterized by an intermediate level of methodological rigour and evidence quality. Subsequent analyses revealed that exercise interventions exert a multifaceted and favourable impact on the therapeutic landscape of VLUs. These interventions distinctly contribute to the enhancement of wound healing rates (risk difference 0.17, 95% confidence interval [CI]: 0.06–0.28) and the extension of ankle range of motion (mean difference [MD] 6.10, 95% CI: 4.61–7.59). Furthermore, Pooled adherence rate was 0.70 (95% CI: 0.20–2.45) with no significant heterogeneity. In conclusion, although existing evidence supports the positive impact of exercise training on VLUs, higher-quality research is still needed to deepen our understanding of its effects and provide more specific guidance for clinical practice.
We aimed to explore the efficacy of maple leaf-shaped flap in the repair of perianal circular skin defect. This study is a retrospective review of patients with perianal circular skin defect after skin tumour resection and repaired with maple leaf-shaped flap. Patients included in this study were admitted in our department between January 2010 and January 2023. A standardized data collection template was used to collect related variables. The design and surgical procedures of maple leaf-shaped flap are carefully described in this study. Negative pressure wound therapy (NPWT) was applied to assist wound healing postoperatively. Twenty-seven patients were included in this study. The average wound size after tumour resection measured 4 × 5 cm2–10 × 10 cm2. The circular skin defect was repaired by maple leaf-shaped flap, and NPWT was used after surgery. Twenty-five patients achieved primary wound healing and flaps were well-survived. Slight infection occurred in two patients, and both were cured after dressing change. During the follow-up period of 6–24 months, no tumour recurrence occurred. The perianal morphology can be well-restored by maple leaf-shaped flap, and the defecation control function of anus was not impaired. The application of maple leaf-shaped flap and NPWT is a promising way in the repair of perianal circular skin defect with little complication and satisfying outcomes.
Chronic prostatitis, which frequently manifests with perineal or urethral ulcers, can have substantial impact on the quality of life experienced by affected individuals. Present treatment approaches primarily target the alleviation of symptoms and control of complications. In patients with chronic prostatitis, this investigation examined the potential synergistic effects of tamsulosin and levofloxacin on urinary function and urethral and perineal wounds healing. This cross-sectional observational study was carried out at Chongqing Western Hospital, China, from February to November 2023. The participants comprised 88 males aged 40–75 years who had been clinically diagnosed with chronic prostatitis and complications that accompany the wound healing process. The participants were equally distributed into two groups: one assigned to the treatment group, which received a daily combination of levofloxacin (500 mg) and tamsulosin (0.4 mg) and other to receive conventional care. The wound healing rate and improvement in urinary function were the primary outcomes evaluated monthly for 9 months. Patient satisfaction and symptom amelioration were secondary outcomes, in addition to the surveillance of adverse effects. In comparison to the control, treatment group exhibited significantly higher rate of wound closure (78.08% at 1 month and 79.38% at 9 months) and urinary function improvement (66.69% at 1 month and 67.95% at 9 months). In addition, the treatment group exhibited a greater degree of symptom amelioration; however, a rise in adverse effects was observed. In every domain, patient satisfaction scores were significantly higher in the treatment group. Thus the combination of tamsulosin and levofloxacin improved urinary function and wound repair in patients with chronic prostatitis, while also exhibiting tolerable profile of adverse effects.
The meta-analysis aimed to assess and compare diabetic foot wound ulcer management by vacuum sealing drainage. Using dichotomous or contentious random- or fixed-effects models, the outcomes of this meta-analysis were examined, and the odds ratio (OR) and the mean difference (MD) with 95% confidence intervals (CIs) were computed. Twenty-three examinations from 2000 to 2023 were enrolled for the present meta-analysis, including 1928 individuals with diabetic foot ulcers. Vacuum sealing drainage had significantly lower wound healing (OR, 2.35; 95% CI, 1.79–3.08, p < 0.001), lower duration of therapy (MD, −6.19; 95% CI, −10.06 to −2.32, p = 0.002), higher wound size reduction (MD, 4.22; 95% CI, 0.87–7.56, p = 0.01) and lower complication (OR, 0.32; 95% CI, 0.13–0.80, p = 0.01) compared with standard therapy in patients with diabetic foot ulcers. The examined data revealed that vacuum sealing drainage had significantly lower wound healing, duration of therapy and complication rates, as well as higher wound size reduction, compared with standard therapy in patients with diabetic foot ulcers. Yet, attention should be paid to its values since most of the selected examinations had a low sample size.
Postoperative Surgical Site Infections (SSIs) pose significant challenges to recovery after joint arthroplasty. This systematic review and meta-analysis aim to compare the incidence of SSIs after knee or hip arthroplasty under Spinal Anaesthesia (SA) versus general anaesthesia (GA). We conducted the systematic review and meta-analysis following the PRISMA guidelines, analysing data from 15 studies selected from PubMed, Embase, Web of Science, and Cochrane Library up to May 16, 2023. The analysis included studies comparing SSIs incidence in patients aged 18 years and above who underwent knee or hip arthroplasty under SA or GA. Quality assessment was performed using the Cochrane Collaboration's risk of bias tool. The effect size was calculated using random or fixed-effects models based on the observed heterogeneity. We assessed the heterogeneity between studies and conducted a sensitivity analysis. Of 1651 initially identified studies, 15 articles encompassing 353 169 patients were included in the final analysis. A total of 156 405 patients were under SA, while 196 764 received GA. The studies demonstrated substantial heterogeneity (p = 0.007, I 2 = 53.7%), resulting in a random-effects model being employed. Patients receiving SA showed a 23% lower likelihood of developing SSIs postoperatively compared to GA patients (OR: 0.77, 95% CI: 0.70–0.86, p < 0.001). Sub-group analysis further confirmed these findings regardless of the type of joint arthroplasty. This meta-analysis indicated a significantly lower incidence of SSIs following knee or hip arthroplasty under SA compared to GA. Despite observed heterogeneity, the results underscore the potential benefit of SA over GA in orthopaedic surgeries to reduce the risk of SSIs.
The meta-analysis aims to evaluate and compare the sternal wound infections following internal mammary artery grafts for a coronary bypass. Examinations comparing bilateral internal mammary artery to single internal mammary artery for coronary artery bypass grafting were among the meta-analyses from various languages that met the inclusion criteria. Using dichotomous random- or fixed-effect models, the results of these investigations were examined, and the Odd Ratio (OR) with 95% confidence intervals (CIs) was computed. A total of 31 examinations from 2001 to 2023 were recruited for the current analysis including 181 503 personals with coronary artery bypass grafting. Bilateral internal mammary artery had significantly higher sternal wound infection (OR, 1.51; 95% CI, 1.37–1.68, p < 0.001), superficial sternal wound infection (OR, 1.72; 95% CI, 1.16–2.56, p = 0.007), deep sternal wound infection (OR, 1.62; 95% CI, 1.41–1.86, p < 0.001), sternal wound infection in diabetics (OR, 1.48; 95% CI, 1.16–1.90, p = 0.002), sternal wound infection in elderly (OR, 1.38; 95% CI, 1.22–1.57, p < 0.001), sternal wound infection in pedicled preparation (OR, 1.70; 95% CI, 1.30–2.23, p < 0.001) and sternal wound infection in skeletonized preparation (OR, 1.40; 95% CI, 1.09–1.81, p = 0.009) compared to single internal mammary artery in personals with coronary artery bypass grafting. Bilateral internal mammary artery grafting is linked to a higher risk of impaired wound healing, particularly in diabetic individuals, elderly, pedicled preparation, and skeletonized preparation. Nevertheless, caution should be exercised while interacting with its values since examinations were performed by different surgeons with different skills on different types of personals.
To evaluate the efficacy of one-step acellular dermis combined with autologous split thickness skin grafting in the treatment of burn or trauma wounds by a multicenter controlled study. In patients with extensive burns, it is even difficult to repair the wounds due to the shortage of autologous skin. The traditional skin grafting method has the disadvantages of large damage to the donor site, insufficient skin source and unsatisfactory appearance, wear resistance and elasticity of the wound tissue after skin grafting. One-step acellular dermis combined with autologous ultra-thin split thickness skin graft can achieve better healing effect in the treatment of burn and trauma wounds. A total of 1208 patients who underwent single-layer skin grafting and one-step composite skin grafting in the First Affiliated Hospital of Wannan Medical College, Wuhan Third People's Hospital and Lu ‘an People's Hospital from 2019 to 2022 were retrospectively analysed. The total hospitalization cost, total operation cost, hospitalization days after surgery, wound healing rate after 1 week of skin grafting and scar follow-up at 6 months after discharge were compared and studied. The total cost of hospitalization and operation in the composite skin grafting group was significantly higher than those in the single-layer autologous skin grafting group. The wound healing rate after 1 week of skin grafting and the VSS score of scar in the follow-up of 6 months after discharge were better than those in the single-layer skin grafting group. One-step acellular dermis combined with autologous ultra-thin split thickness skin graft has high wound healing rate, less scar, smooth appearance and good elasticity in repairing burn and trauma wounds, which can provide an ideal repair method for wounds.
A meta-analysis study was executed to measure the effect of minimally invasive surgery (MIS) and open surgical management (OSM) on wound infection (WI) in female's cervical cancer (CC). A comprehensive literature study till February 2023 was applied and 1675 interrelated investigations were reviewed. The 41 chosen investigations enclosed 10 204 females with CC and were in the chosen investigations' starting point, 4294 of them were utilizing MIS, and 5910 were utilizing OSM. Odds ratio (OR) in addition to 95% confidence intervals (CIs) were utilized to compute the value of the effect of MIS and OSM on WI in female's CC and by the dichotomous approaches and a fixed or random model. The MIS had significantly lower WI (OR, 0.23; 95% CI, 0.15–0.35, p < 0.001) with no heterogeneity (I 2 = 0%) and postoperative aggregate complications (PACs) (OR, 0.49; 95% CI, 0.37–0.64, p < 0.001) in females with CC and compared OSM. However, MIS compared with OSM in females with CC and had no significant difference in pelvic infection and abscess (PIA) (OR, 0.59; 95% CI, 0.31–1.16, p = 0.13). The MIS had significantly lower WI, and PACs, though, had no significant difference in PIA in females with CC and compared with OSM. However, care must be exercised when dealing with its values because of the low sample size of some of the nominated investigations for the meta-analysis.
The assessment for safety and effectiveness of surgical interventions in the management of diabetic foot ulcers (DFUs) in comparison to non-surgical approaches was performed. A comprehensive search was performed across PubMed, MEDLINE, Cochrane Library and EMBASE in order to identify case–control studies, randomized controlled trials (RCTs), observational studies, cohort studies and observational studies pertaining to DFU treatments. Studies conducted in English language and focusing on wound healing rates, recurrence rates, time to healing and complication management met the inclusion criteria. There were six studies included in this meta-analysis. Surgical procedures, such as debridement, revascularization and skin transplantation, demonstrated significantly superior efficacy in promoting wound healing (84%) and shorter duration of healing (6 weeks) in comparison to non-surgical approaches, including off-loading, wound dressings and pharmacological therapies. Surgical interventions for DFUs resulted in a wound recovery rate of 84%, a significantly higher mean rate than non-surgical approaches (60%) that was observed. In addition, it was observed that the surgical group experienced considerably reduced average healing period of 9 weeks, in contrast to the non-surgical group's mean healing period of 12 weeks. Nevertheless, it is imperative to acknowledge that surgical procedures were notably correlated with a heightened occurrence of complications, such as amputations, which transpired in 19% of instances. Surgical interventions for DFUs may provide superior short-term results with regard to healing rates and recovery time, as indicated by this meta-analysis. However, they are additionally correlated with the heightened likelihood of complications. Although non-surgical techniques offered comparatively secure option, they were also less reliable. Individualized treatment modalities should be chosen in consideration of patient-specific factors and comparative advantages and disadvantages.
This systematic review and meta-analysis evaluate the impact of ultrasound-guided subsheath versus extrasheath sciatic nerve blocks on postoperative wound pain in tibial and foot surgeries, crucial for effective pain management and patient recovery. Adhering to PRISMA guidelines, this study used a PICO framework, focusing on patients undergoing tibial and foot surgeries and comparing the efficacy and safety of subsheath and extrasheath sciatic nerve blocks. The literature search spanned four databases without time restrictions, assessing various outcomes like success rate, onset time, duration of analgesia and complication rates. Quality assessment employed the Cochrane Collaboration's risk of bias tool, and statistical analyses included heterogeneity assessment, fixed-effect and random-effects models, sensitivity analysis and publication bias evaluation using funnel plots and Egger's linear regression test. From an initial pool of 1213 articles, six met the inclusion criteria. The subsheath group showed a significantly higher success rate of complete sensory blockade within 30 min compared with the extrasheath group (OR = 5.39; 95% CI: 2.82–10.28; p < 0.01). No significant differences were found in procedure duration or incidence of nerve-related complications between the two techniques. The subsheath approach also demonstrated a quicker onset time of sensory blockade (MD = −8.57; 95% CI: −11.27 to −5.88; p < 0.01). Sensitivity analysis confirmed the stability of the results, and no significant publication bias was detected. Ultrasound-guided subsheath sciatic nerve blocks are more effective than extrasheath blocks in achieving rapid and complete sensory blockade for tibial and foot surgeries, with a quicker onset time and comparable safety profile. Subsheath injections are thus recommended as a preferred method for anaesthesia and postoperative pain management in these surgical procedures, enhancing overall patient outcomes.
This meta-analysis evaluates the efficacy of silver alginate dressings (SAD) compared to standard gauze (SG) in enhancing wound healing and reducing scar formation post-mastectomy in patients with triple-negative breast cancer. From an initial pool of 1245 articles, five studies met the inclusion criteria. The analysis revealed that SAD significantly improve early wound healing 1 week post-mastectomy, as indicated by lower Redness, Edema, Ecchymosis, Discharge, and Approximation (REEDA) scales (I 2 = 85%; Random: SMD: −7.08, 95% CI: −8.26 to −5.98, p < 0.01), compared to SG. Additionally, long-term scar outcomes measured by the Manchester Scar Scale (MSS) 5 months post-mastectomy showed a notable reduction in scar formation (I 2 = 95%; Random: SMD: −12.97, 95% CI: −16.20 to −9.75, p < 0.01)) in the silver alginate group. The findings support the use of SAD in post-mastectomy care for triple-negative breast cancer patients but highlight the need for further research on long-term safety and cost-effectiveness.
Various factors contribute to different types of surgical site infections (SSI) in gastric cancer patients undergoing surgery, and the risk factors remain uncertain. This meta-analysis aims to clarify the relationship between various factors and SSI, resolving existing controversies. Thirty-four eligible articles with 66 066 patients were included in the meta-analysis. Significant risk factors for SSI included age ≥65 years, male gender, BMI ≥25 kg/m2, diabetes, hypertension, advanced TNM stage ≥III, pathologic T stage ≥T3, pathologic N stage ≥N1, ASA ≥3, open surgery, blood transfusion, extensive resection, combined resection, splenectomy, D2 or more lymph node dissection, and operative time ≥240 min. Operative time showed a nonlinear relationship with SSI risk. Subgroup analysis revealed significant differences in the effects of risk factors among different infection types. These findings inform the development of targeted preventive measures to reduce SSI rates.
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.
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