RESUMO
BACKGROUND: A new barb suture has been extensively applied in clinical practice of surgery and has achieved good efficacy. However, its application in total knee arthroplasty is little, and the treatment efficacy remains controversial. OBJECTIVE: To collect the related studies for systematic analysis, so as to provide evidence for the use of barbed suture in total knee arthroplasty. METHODS: PubMed, EMBASE, Cochrane library, CBM, CNKI, Wanfang and VIP databases were retrieved by two researchers independently for the randomized controlled trials on barbed suture and traditional suture applied in total knee arthroplasty published before June 2019. Literature quality was assessed using the randomized controlled trials bias risk assessment tool recommended by the Cochrane manual, and meta-analysis was performed using RevMan 5.3 software. RESULTS AND CONCLUSION: (1) Eight randomized controlled trials were included, involving 1 004 knees. (2) The results showed that barbed suture could significantly shorten the wound closure time [MD=-5.17, 95%CI(-6.26, -4.09), P < 0.000 01] and reduce the total cost of wound closure [SMD=-1.66, 95%CI(-2.58, -0.75), P=0.000 4], and incidence of acupuncture injury [RR=0.14, 95%CI(0.03, 0.78), P=0.02]. (3) There was no significant difference in the postoperative complications [RR=0.96, 95%CI(0.65, 1.42), P=0.85], and suture breakage [RR=4.58, 95%CI(0.16, 128.29), P=0.37], range of motion at postoperative 6 weeks and 3 months [MD=-0.74, 95%CI(-4.19, 2.71), P=0.67]; [MD=-0.30, 95%CI(-2.62, 2.02), P=0.80] or American Knee Society Knee Score at postoperative 6 weeks [MD=-0.22, 95%CI(-3.10, 2.66), P=0.88]. The American Knee Society Knee Score at postoperative 3 months was better in the barbed suture group [MD=-2.04, 95%CI(-3.92, -0.15), P=0.03]. (4) To conclude, barbed suture is a fast, low-cost, safe and effective method in primary total knee arthroplasty, which is worthy of clinical use. More randomized controlled trials and long follow-up are needed to confirm this conclusion.
RESUMO
Objective To analyze the application effect of non-penetrating vascular closure system in portal vein reconstruction of allogenic liver transplantation in adults. Methods Clinical data of 222 patients undergoing allogeneic liver transplantation were retrospectively analyzed. According to whether vascular closure system was used in portal vein reconstruction during operation, all patients were divided into vascular clip group (n=137) and traditional suture group (n=85). Perioperative conditions, clinical prognosis and complications were statistically compared between two groups. Results All patients successfully completed the surgery. The success rate of one-time portal vein anastomosis was 93.4% (128/137) in the vascular clip group. A total of 14 patients died during perioperative period in this study with a mortality rate of 6.3% (14/222). No portal vein-related complications occurred during perioperative period in both groups. The time of portal vein anastomosis in the vascular clip group was (5.6±1.7) min, which was significantly shorter than (10.7±3.6) min in the traditional suture group (P<0.05). The incidence and grade of perioperative complications did not significantly differ between two groups (all P>0.05). Conclusions It is safe and feasible to utilize vascular closure system to reconstruct the portal vein during liver transplantation. Compared with traditional suture, it can effectively shorten the time of portal vein anastomosis.