Articles: sutures.
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Cochrane Db Syst Rev · Jan 2010
Review Meta AnalysisStaples versus sutures for closing leg wounds after vein graft harvesting for coronary artery bypass surgery.
Surgical site infection (SSI) after saphenous vein graft harvesting is a complication occurring in up to 18% of patients who undergo coronary artery bypass surgery (CABG). It is not known whether the method of skin closure influences the infection rate. ⋯ These results suggest that there is no evidence of a difference in the risk of SSI and wound dehiscence when staples rather than sutures are used to close leg wounds after vein graft harvesting during CABG, however more research is needed.
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Cochrane Db Syst Rev · Jan 2010
Review Meta AnalysisTissue adhesives for closure of surgical incisions.
Sutures, staples and adhesive tapes are the traditional methods of wound closure, whilst tissue adhesives have entered clinical practice more recently. Closure of wounds with sutures enables meticulous closure, but they may show tissue reactivity and can require removal. Tissue adhesives offer the advantages of no risk of needlestick injury and no requirement to remove sutures later. Tissue adhesives have been used primarily in emergency rooms but this review looks at the use of tissue adhesives in the operating room where surgeons are increasingly using these for the closure of surgical skin incisions. ⋯ Sutures were significantly better than tissue adhesives for minimising dehiscence and were found to be significantly faster to use. Although surgeons may consider the use of tissue adhesives as an alternative to other methods of surgical site closure in the operating theatre they must be aware that adhesives may take more time to apply and that if higher tension is needed upon an incision, sutures may minimise dehiscence. There is a need for more well designed randomised controlled trials comparing tissue adhesives and alternative methods of closure. These trials should include people whose health may interfere with wound healing and surgical sites of high tension.
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Review Meta Analysis
Prospective clinical trials of thyroidectomy with LigaSure vs conventional vessel ligation: a systematic review and meta-analysis.
To evaluate the hemostatic effects and safety of thyroidectomy performed using the LigaSure vessel-sealing device (Valleylab, Boulder, Colorado) or the conventional vessel ligation. ⋯ The LigaSure technique may provide a safe, effective, and fast alternative to conventional vessel ligation in thyroidectomy and may result in a significant reduction in operative duration. However, it may not confer any advantage over conventional thyroidectomy in terms of the amount of intraoperative blood loss, length of hospital stay, and postoperative complication rates.
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J. Gastrointest. Surg. · May 2008
Meta Analysis Comparative StudyComparison of stapled versus handsewn loop ileostomy closure: a meta-analysis.
The purpose of this study was to compare the rates of small bowel obstruction, anastomotic complications, and wound infections between stapled and handsewn closures of loop ileostomies. A literature search in Embase, PubMed, and Cochrane Database for Clinical Trials using search terms "closure," "loop ileostomy," and "stapled" was performed. All abstracts were reviewed to identify relevant articles, and their references were hand searched for additional studies. ⋯ Two studies showed shorter operative times favoring stapled anastomoses. No difference was seen in length of stay. Current literature suggests no statistically significant differences between stapled and hand-sewn loop ileostomy closures, but there may be a trend favoring stapled closures with regard to lower small bowel obstruction rates and shorter operative time.
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Pediatric emergency care · May 2007
Meta Analysis Comparative StudyAbsorbable versus nonabsorbable sutures in the management of traumatic lacerations and surgical wounds: a meta-analysis.
To complete a systematic review of randomized controlled trials (RCTs) that compare the cosmetic outcomes and complications of traumatic lacerations and surgical incisions closed with absorbable sutures versus nonabsorbable sutures. ⋯ Our meta-analysis suggests a lack of large, methodologically sound RCTs evaluating the effectiveness of absorbable versus nonabsorbable sutures. Although our analysis demonstrates that nonabsorbable sutures seem to be no better than absorbable sutures in the management of wound repair, a large methodologically sound RCT is needed to adequately answer this question.