Articles: sutures.
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Cochrane Db Syst Rev · Feb 2017
Review Meta AnalysisMesh fixation with glue versus suture for chronic pain and recurrence in Lichtenstein inguinal hernioplasty.
Chronic pain following mesh-based inguinal hernia repair is frequently reported, and has a significant impact on quality of life. Whether mesh fixation with glue can reduce chronic pain without increasing the recurrence rate is still controversial. ⋯ Based on the short-term results, glue may reduce postoperative chronic pain and not simultaneously increase the recurrence rate, compared with sutures for mesh fixation in Lichtenstein hernia repair. Glue may therefore be a sensible alternative to suture for mesh fixation in Lichtenstein repair. Larger trials with longer follow-up and high quality are warranted. The difference between synthetic glue and biological glue should also be assessed in the future.
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Review Meta Analysis Comparative Study
Fibrin glue versus staple for mesh fixation in laparoscopic transabdominal preperitoneal repair of inguinal hernia: a meta-analysis and systematic review.
The aim of this study was to compare outcomes of mesh fixation using fibrin glue versus staple in laparoscopic transabdominal preperitoneal (TAPP) repair of inguinal hernia. ⋯ Our meta-analysis and systematic review shows that the use of fibrin glue fixation may provide an alternative approach to staple fixation in TAPP inguinal hernia repair without increasing the postoperative morbidity. Large-scale RCTs with long-term follow-up are still needed to further assess postoperative outcomes such as chronic pain and disease recurrence.
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Review Meta Analysis
Meta-analysis and trial sequential analysis of triclosan-coated sutures for the prevention of surgical-site infection.
Triclosan-coated sutures (TCS) were developed to reduce the risk of surgical-site infection (SSI). Level 1A evidence of effectiveness has been presented in various recent meta-analyses, yet well designed RCTs have not been able to reproduce these favourable results. The aim of this study was to evaluate all available evidence critically with comprehensive analysis to seek a more reliable answer regarding the effectiveness of TCS in the prevention of SSI. ⋯ GRADE assessment shows moderate-quality evidence that TCS are effective in reducing SSI. Trial sequential analysis indicates that the effect was robust, and additional data are unlikely to alter the summary effect.
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Review Meta Analysis
Meta-analysis of the potential economic impact following introduction of absorbable antimicrobial sutures.
Despite several randomized trials, systematic reviews and meta-analyses that have demonstrated the effectiveness of antimicrobial (triclosan-coated or -impregnated) sutures (TCS), the clinical and economic impact of using these sutures compared with conventional non-antimicrobial-coated absorbable sutures (NCS) remains poorly documented. ⋯ The reviewed literature suggested that antimicrobial sutures may result in significant savings across various surgical wound types.
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Cochrane Db Syst Rev · Dec 2016
Review Meta AnalysisFibrin glue versus sutures for conjunctival autografting in primary pterygium surgery.
Pterygium, a growth of the conjunctiva over the cornea, is a progressive disease leading in advanced stages to visual impairment, restriction of ocular motility, chronic inflammation and cosmetic concerns. Surgical removal is the treatment of choice, but recurrence can be a problem. Currently the best surgical option in terms of recurrence is conjunctival autograft. To date the most common surgical methods of attaching conjunctival autografts to the sclera are through suturing or fibrin glue. Each method presents its own advantages and disadvantages. Sutures require considerable skill from the surgeon and can be associated with a prolonged operation time, postoperative discomfort and suture-related complications, whereas fibrin glue may give a decreased operation time, improve postoperative comfort and avoid suture-related problems. ⋯ The meta-analyses, conducted on people with pterygium in a hospital or outpatient setting, show fibrin glue may result in less recurrence and may take less time than sutures for fixing the conjunctival graft in place during pterygium surgery. There was low-certainty evidence to suggest a higher proportion of complications in the fibrin glue group.