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1.
World J Gastrointest Surg ; 6(12): 241-7, 2014 Dec 27.
Article in English | MEDLINE | ID: mdl-25548609

ABSTRACT

AIM: To report a systematic review of published randomized controlled trials (RCTs) investigating the role of absorbable suture (AS) against non-AS (NAS) used for the closure of surgical incisions. METHODS: RCTs investigating the use of AS vs NAS for the closure of surgical incisions were statistically analysed based upon the principles of meta-analysis and the summated outcomes were represented as OR. RESULTS: The systematic search of medical literature yielded 10 RCTs on 1354 patients. Prevalence of wound infection (OR = 0.97; 95%CI: 0.56, 1.69; Z = 0.11; P = 0.92) and operative morbidity (P = 0.45) was comparable in both groups. Nonetheless, the use of AS lead to lower risk of wound break-down (OR = 0.12; 95%CI: 0.04, 0.39; Z = 3.52; P < 0.0004). CONCLUSION: This meta-analysis of 10 RCTs demonstrates that the use of AS is similar to NAS for skin closure for surgical site infection and other operative morbidities. AS do not increase the risk of skin wound dehiscence, rather lead to a reduced risk of wound dehiscence compared to NAS.

2.
Am J Surg ; 205(6): 726-36, 2013 Jun.
Article in English | MEDLINE | ID: mdl-23561639

ABSTRACT

BACKGROUND: A systematic analysis was conducted of randomized controlled trials (RCTs) comparing lightweight mesh (LWM) with heavyweight mesh in laparoscopic inguinal hernia repair. METHODS: Data extracted from the included RCTs were analyzed according to the principles of meta-analysis. RESULTS: Eleven RCTs encompassing 2,189 patients were analyzed. In a fixed-effects model, operating time, postoperative pain, and recurrence rate were statistically similar between LWM and heavyweight mesh. LWM was associated with fewer perioperative complications and a reduced risk for developing chronic groin pain. There was also a reduced risk for developing other groin symptoms, such as foreign body sensations, but it was not statistically significant. CONCLUSIONS: The use of LWM for laparoscopic inguinal hernia repair is not associated with an increased risk for hernia recurrence. LWM reduces the incidence of chronic groin pain, groin stiffness, and foreign body sensations. Therefore, LWM may routinely be used in laparoscopic inguinal hernia repair. However, high-quality RCTs with longer follow-up periods are required to validate these findings.


Subject(s)
Chronic Pain/etiology , Groin , Hernia, Inguinal/surgery , Laparoscopy , Surgical Mesh/adverse effects , Equipment Design , Herniorrhaphy/instrumentation , Humans , Randomized Controlled Trials as Topic
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