Role of prolonged packing in postoperative anorectal abscess management: a systematic review and meta-analysis.

IF 2.2 4区 医学 Q2 SURGERY
Canadian Journal of Surgery Pub Date : 2024-09-27 Print Date: 2024-09-01 DOI:10.1503/cjs.008423
Dain Raina Kim, Kevin Verhoeff, Uzair Jogiat, Alex Miles, Janice Y Kung, Valentin Mocanu
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引用次数: 0

Abstract

Background: Prolonged packing of anorectal abscess cavities with internal dressings after incision and drainage is frequently used, but the efficacy of this practice remains controversial. Some studies highlight its use in hemostasis and preventing fistula and abscess recurrence, whereas others describe its economic burden and increase in pain. In this systematic review, we examine current evidence on the impact of packing after incision and drainage for anorectal abscesses.

Methods: The medical librarian conducted a comprehensive literature search on January 5, 2023. We conducted the meta-analysis using RevMan 5.4.1 software with a Mantel-Haenszel random-effects model.

Results: We identified 3 randomized controlled trials, comprising 490 patients. Of those, 241 patients (49%) received postoperative packing; most patients were male (n = 158, 65.6%), with a median age of 40.5 years and a follow-up of 6 months. Meta-analysis showed that prolonged wound packing was associated with delayed wound healing and increased pain, but no difference in abscess recurrence or fistula formation.

Conclusion: In this systematic review of current evidence highlighting the impact of packing after incision and drainage for anorectal abscesses, we found that the practice is not associated with significant differences in abscess recurrence and fistula formation, but is associated with increased postoperative pain and delayed wound healing.

长时间填料在术后肛门直肠脓肿处理中的作用:系统综述和荟萃分析。
背景:肛门直肠脓肿切开引流后,经常使用内敷料对脓肿腔进行长时间包扎,但这种做法的效果仍存在争议。一些研究强调了其止血和预防瘘管及脓肿复发的作用,而另一些研究则描述了其经济负担和增加的疼痛。在这篇系统性综述中,我们研究了目前有关肛门直肠脓肿切开引流术后填料的影响的证据:医学图书管理员于 2023 年 1 月 5 日进行了全面的文献检索。我们使用 RevMan 5.4.1 软件和 Mantel-Haenszel 随机效应模型进行了荟萃分析:我们确定了 3 项随机对照试验,共涉及 490 名患者。其中,241 名患者(49%)接受了术后包扎;大多数患者为男性(n = 158,65.6%),中位年龄为 40.5 岁,随访时间为 6 个月。荟萃分析表明,长时间的伤口填塞与伤口愈合延迟和疼痛加剧有关,但在脓肿复发或瘘管形成方面没有差异:在这一系统性综述中,我们发现在肛门直肠脓肿切开引流术后进行伤口填塞与脓肿复发和瘘管形成的显著差异无关,但与术后疼痛加剧和伤口愈合延迟有关。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
3.00
自引率
8.00%
发文量
120
审稿时长
6-12 weeks
期刊介绍: The mission of CJS is to contribute to the meaningful continuing medical education of Canadian surgical specialists, and to provide surgeons with an effective vehicle for the dissemination of observations in the areas of clinical and basic science research.
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