The Role of Postoperative Dressing in Hypospadias Surgery: A Systematic Review and Meta-analysis of the Pediatric Literature.

IF 1.5 3区 医学 Q2 PEDIATRICS
European Journal of Pediatric Surgery Pub Date : 2023-12-01 Epub Date: 2023-03-07 DOI:10.1055/a-2048-7486
Maria Escolino, Luisa Florio, Giovanni Esposito, Ciro Esposito
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Abstract

This study aimed to describe the available dressings and their management in patients undergoing hypospadias repair and compare postoperative outcomes with and without dressing and between the different dressing types. A comprehensive electronic literature search of PubMed, Embase, and Cochrane Library was conducted to obtain studies, published in the period 1990 to 2021, reporting on the dressing used following hypospadias surgery. All information regarding the dressing was considered as primary endpoints, whereas surgical outcomes were assessed as secondary outcomes. Thirty-one studies containing 1,790 subjects undergoing hypospadias repair were included. Dressings were divided into three categories: nonadherent to the wound, adherent to the wound, and glue-based dressings. Most authors preferred to remove/change the dressing in the ward and the median time of removal/change was 6.56 postoperative days. The dressing removal appeared as the most frequent factor generating parental anxiety. The median rate of wound-related complications was 8.18%, of urethroplasty complications 9.08% and of reoperations 8.18%. Meta-analysis of outcomes showed higher risk of reoperations using conventional dressing, with no differences in urethroplasty and wound-related complications rates between conventional and glue-based dressings. Furthermore, the use of dressing reported increased risk of wound-related complications compared with no dressing, without significant differences regarding occurrence of urethroplasty complications and reoperations. The current evidence confirmed that there is no difference in outcomes of hypospadias repair depending on a certain dressing type. To date, surgeon's preference remains the main factor determining the choice for a specific dressing or for no dressing at all.

尿道下裂手术中术后敷料的作用:儿科文献的系统回顾与元分析》。
本研究旨在描述尿道下裂修补术患者可用的敷料及其处理方法,并比较使用和不使用敷料以及不同类型敷料的术后效果。研究人员对PubMed、Embase和Cochrane图书馆进行了全面的电子文献检索,以获取1990年至2021年期间发表的有关尿道下裂手术后使用敷料的研究报告。有关敷料的所有信息均被视为主要终点,而手术结果则被评估为次要终点。31项研究共纳入了1790名接受尿道下裂修补术的受试者。敷料分为三类:与伤口不粘连的敷料、与伤口粘连的敷料和基于胶水的敷料。大多数作者倾向于在病房内去除/更换敷料,术后去除/更换敷料的中位时间为 6.56 天。移除敷料似乎是引起家长焦虑的最常见因素。伤口相关并发症的中位发生率为 8.18%,尿道成形术并发症的中位发生率为 9.08%,再次手术的中位发生率为 8.18%。对结果的 Meta 分析表明,使用传统敷料的再手术风险更高,而传统敷料和胶水敷料在尿道成形术和伤口相关并发症的发生率上没有差异。此外,与不使用敷料相比,使用敷料会增加伤口相关并发症的风险,但尿道成形术并发症和再次手术的发生率无明显差异。目前的证据证实,尿道下裂修补术的结果并不因敷料类型的不同而有所差异。迄今为止,外科医生的偏好仍是决定选择特定敷料还是不使用敷料的主要因素。
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
3.90
自引率
5.60%
发文量
66
审稿时长
6-12 weeks
期刊介绍: This broad-based international journal updates you on vital developments in pediatric surgery through original articles, abstracts of the literature, and meeting announcements. You will find state-of-the-art information on: abdominal and thoracic surgery neurosurgery urology gynecology oncology orthopaedics traumatology anesthesiology child pathology embryology morphology Written by surgeons, physicians, anesthesiologists, radiologists, and others involved in the surgical care of neonates, infants, and children, the EJPS is an indispensable resource for all specialists.
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